Objctive:To find an effective clinical method for caleaneal pain .Methods: 68 Cases of caleaneal pain in clinic service were collected from August 2006 to August 2008, and were treated with radix decoctum and Biqi Capsule. Tracing observation was used to evaluate the curative effect. Results: 41 Cases were healing well, 24 cases were improving, 3 cases were useless. The total effective rate was 95.6%. Conclusion: Radix decoctum with Biqi Capsule was an effective method for caleaneal pain.

Objective To explore a legal system which helps to provide effective HIV prevention and treatment for commercial sex workers.Method A method of literature review was adopted to analyse the major international literature on the interaction between sex work law and HIV prevention and treatment.Results In an international perspective,there are generally three types of legal frameworks of sex work:prohibitive law,law of regulating sex work through licensing,and decriminalization of sex work.In terms of public health,the prohibitive law drives sex workers to the underground state,hindering HIV/AIDS prevetion and treatment;the law of regulating sex work through licensing is unable to deal with the health problems of the unlicensed sex workers;decriminalization of sex work can not only avoid driving sex workers to the underground state,but can also advance HIV/AIDS prevention and treatment by providing integrated health service and behavioural interventions.Conclusion Among the three legal approaches to sex work,decriminalization of sex work provides the most enabling legal framework for HIV prevention and treatment in sex work community.

Objective To probe into the effect of early psychological care on negative emotions and sleep of elderly patients with chronic heart failure. Methods 96 patients elderly patients with chronic heart failure were selected from June 2009 to June 2010, and were randomly divided into the study group and the control group with 48 patients in each group. Two groups of elderly patients were given traditional routine care after diagnosis, and elderly patients in the study group were given early comprehensive psychological nursing intervention additionally. Clinical index such as negative mood and sleep were analyzed. Results Compared with the control group, anxiety and depression scores of the study group were significantly decreased, somatization, obsessive-compulsive symptoms, depression and anxiety were significantly decreased, awakening time, and arousals were significantly lower, and sleep efficiency and sleep maintenance rate was significantly increased, there were significant differences. Conclusions Early psychological care for elderly patients with chronic heart failure is very important to improve negative mood and sleep quality for them, and is worth further clinical promotion and application.

Objective Through investigation on hospital infection, to learn the actual status of hospital infection and improve hospital infection management work continuously. Methods Via transect investigation, all hospital-ized patients were investigated by bed-visiting and patients, medical records, checking at the same time. ResultsA total of 3032 cases were enrolled, and the prevalence from 2010 to 2012 were 6. 10%, 5.30% and 4.17%, re-spectively. ICU had the highest prevalence of 39.29%. The lower respiratory tract ranked the first place (45.16%) among infection sites. Invasive operation increased the risk of nosocomial infections. The utilization rates of antibiotics of the hospitalized patients from 2010 to 2012 were 67.7%, 64. 8%, and 54. 1%, respectively. The microbial submission rates for the therapeutic medication were 39 . 00%, 46.99%, and 55 . 01%, respective-ly. The gram-negative bacteria were dominant among the isolated bacterias, accounting for 61.39%. ConclusionThe prevalence survey in the nearly three years shows that the prevalence of nosocomial infections is decreasing,and the microbial submission rate for the therapeutic medication is also increasing by improved hospitalized conditions, strict management of antibiotics and enhanced surveillance.

OBJECTIVE To study the washing effect of three different methods with the multienzymatic detergent to keep the surgical instruments moist.METHODS The surgical instruments which were selected within five days were washed by three different methods with the multienzymatic detergent to keep moist.The washing effect was compared by eyes and with 5 times magnifying glass and with OB test paper.RESULTS There were prominent difference to washing effect among three methods to keep the surgical instruments moist(P

Circulating tumor markers have been paid more attention in the application of the treatment for breast cancer, the level of which has extended from protein to gene, including traditional tumor markers, HER-2 extracellular domain, circulating tumor cells, circulating tumor DNA (ctDNA), circulating RNA (ctRNA) and so on. As “liquid detection”, the detection of circulating tumor markers with real-time dynamic, easy operation, good reproducibility and other advantages are widely used in aiding early diagnosis, determining prognosis, prospectively predicting response or resistance to speciifc therapies, surveillance after primary surgery, and monitoring therapy in patients with advanced disease, The further study of circulating tumor markers may contribute to patient’s individual treatment.

Objective To compare the effects of ephedrine and dopamine in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery.Methods Fifty ASAⅠorⅡ patients undergoing elective cesarean delivery were randomly divided into the two groups,Ephedrine group (n=5 1 ):intrave-nous injection of 10mg ephedrine before anesthesia;Dopamine group(n=52):continuous intravenous infusion at the speed of 5μg·kg-1 ·min-1 .During the whole process,we investigated the incidence rate of adverse effects,com-pared the Apgar score of neonate and analyzed blood gas of umbilical artery and vein.Results Compare to the dopa-mine group,the incidence rate of hypotension was lower in the ephedrine group (43.1% vs 69.2%,χ2 =7.06,P=0.00).The pH value of umbilical artery and 1 min Apgar score of neonate in the ephedrine group was lower compare with that in the dopamine group[(7.22 ±0.03)vs (7.27 ±0.06),t=0.62,P=0.02],there are no significant difference of 5 min Apgar score in the two groups.Conclusion Compared with dopamine,ephedrine is a useful drug in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery and there are no significant differences of adverse effects of dopamine and ephedrine.Ephedrine has transient effect on the neonate,while the effect of dopamine is minor.

Objective To discuss the pharmaceutical care protocol and methods for clinical pharmacists taking part in cancer pain management. Methods A patient developed delirium and drowsiness after using oxycodone hydrochloride prolonged-release tablet ( OXYCONTIN) and morphine hydrochloride tablet for pain titration treatment. The clinical pharmacist analyzed the reasons of delirium and drowsiness,and suggested a dose reduction of OXYCONTIN or converting OXYCONTIN to another opioid analgesic. Results The suggestion of the clinical pharmacist was partly accepted. After adjusting the treatment, the delirium and drowsiness disappeared gradually, and the pain was well controlled. Conclusion In clinical practice, especially when faced with a rare adverse drug reaction, clinical pharmacists are helpful for ensuring the safety and effectiveness in pain management, as well as improving the level of the treatment, by the implementation of individualized drug therapy.

Objective To investigate the correlation betw een the cerebral w atershed infarction (WSI) types and cerebrovascular stenosis. Methods Patients w ith WSI diagnosed by MRI and diffusion -w eighted imaging w ere enroled. Color Doppler ultrasound w as used to conduct extracranial internal carotid artery (ICA) examination. Magnetic resonance angiography w as used to conduct intracranial vascular examination. The patients w ith WSI w ere divided into cortical w atershed infarction (CWSI), internal w atershed infarction (IWSI), and mixed-type w atershed infarction (MWSI). The correlation betw een the different types of WSI and cerebral vascular stenosis w ere analyzed. Results A total of 120 patients w ith WSI w ere enroled, including 18 w ith CWSI, 48 w ith IWSI, and 54 w ith MWSI. Ipsilateral vascular stenosis: 48 patients w ere in ICA (40.0%, 22 of them in the extracranial segment, 39 in the intracranial segment), 24 (20 .0%) w ere in the anterior cerebral artery, 86 (71.7%) w ere in the middle cerebral artery, 40 (33.3%) w ere in the posterior cerebral artery, 35 (29.2%) w ere in the vertebral basilar artery, and 36 (30.0%) w ere in ICA +MCA. There w ere significant differences in the detection rates of ipsilateral ICA, MCA and ICA + MCA stenosis among different types of WSI. Multivariate logistic regression analysis show ed that CWSI often accompanied by the ipsilateral ICA stenosis (odds ratio [ OR] 0.022; 95% confidence interval [ CI] 0.002 -0.230; P =0.001); IWSI often accompanied by the MCA stenosis ( OR 40.164; 95% CI 3.861 -417.810; P =0.002), w hile MWSI often accompanied by the ipsilateral MCA stenosis ( OR 9.586; 95% CI
2.776 -33.126; P <0.001) and ipsilateral ICA + MCA stenoses ( OR 7.481; 95% CI 2.541 -22.022; P <0.001). Conclusion There w ere significant differences in the incidence of the ipsilateral ICA, MCA, and ICA + MCA stenosis among the different types of WSI. CWSI often accompanied by the ipsilateral ICA stenosis, IWSI often accompanied by the ipsilateral MCA stenosis, and MWSI often accompanied by the ipsilateral ICA + MCA stenosis.

Adaptive radiotherapy (ART) is the product of excellence technology.It reschedules,registers according to tumor's size,shape and alteration of relative position with the surrounding tissue during the treatment.Thereby it raises the accuracy of the conformal radiotherapy.The technology is gradually being chosen by more and more patients.The technology can increase the rate of local control significantly,while reducing the occurrence of radiation-related adverse reactions.