Doctor's degree is the highest degree for medical education.Nowadays,medical doctor candidates in more and more medical universities are requested to publish research papers in intemational journals embodied in Science Citation Index(SCI),or they can not graduate with doctor's degree.So,it is significant for medical doctor candidates to learn the related knowledge about SCI and Impact Factor(IF).

Objective To explore the application of adenosine triphosphate (ATP )bioluminescence assay in evaluating cleaning quality of medical devices.Methods Manual and machine cleaned medical devices were randomly selected from central sterile supply department of a hospital in 2011 -2013,cleaning quality was detected with ATP biolumi-nescence assay,relative light unit (RLU)value was determined to assess the cleaning quality.Results A total of 460 pieces of cleaned devices were detected in 2011 -2013,404 (87.83%)were qualified.The qualified rates of manual cleaning and machine cleaning were 70.73% and 94.07% respectively,the qualified rates of general surgical devices and lumen devices were 90.71 % and 81 .76% respectively,there were significant differences in qualified rates of different cleaning methods and different categories of medical devices (both P <0.01 ).The qualified rates of manual cleaning in 2011 - 2013 were 32.35%,79.63%,and 94.29% respectively,machine cleaning were 79.45%,98.15%,and 98.08% respectively;differences in qualified rates of manual cleaning and machine cleaning in different years were significant (all P <0.01 ).Conclusion ATP bioluminescence assay can be used for evalua-ting cleaning quality of medical devices.

Female ; Genes, p53 ; immunology ; Humans ; Ovarian Neoplasms ; genetics ; pathology ; Ovary ; pathology ; Proto-Oncogene Proteins ; immunology ; metabolism ; Proto-Oncogene Proteins p21(ras) ; Proto-Oncogenes ; immunology ; Sertoli-Leydig Cell Tumor ; genetics ; pathology ; ras Proteins ; immunology ; metabolism

This study aimed to study the criteria of two-way referral between tertiary-care hospital and communityhealth-care service center for patients with cerebralhemorrhage and a protocol of implementation to promote its treatment and rehabilitation.The criteria of two-way referral between tertiarycare hospital and community health-care service center for patients with cerebral hemorrhage after surgical operation were formulated on a trial basis with mutual consultation by the department of neurosurgery,Shenzhou hospital affiliated to Shenyang Medical College and Hunhewan Community Health-Care Service Center,Heping district,Shenyang. Totally,91 patients of cerebral hemorrhage admitted to the hospital during October 2007 to September 2010 were recruited for the study,46 in the intervention group with two-way referral and 45 in the control group by self-referral determined by their family members.All the patients of the two groups were followed-up for three years.During the follow-up in the intervention group,40 of 46 (95％) patients could comply with taking medication ordered by physicians,ability of daily living remarkably improved by Barthel index in 21 (50％),physical function recovered well in 33 (79％),34 (81％) could insist in self-monitoring and 32 (76％) could visit physicians for regular consultation,all these being significantly better than those in the control group (64％,31％,28％,25％ and 25％,respectively) (P ＜0.01 ).Medical and rehabilitative cost for patients with cerebral hemorrhage accounted for 575 RMB yuan per month in intervention group,as compared to 2246 RMB yuan for those in control group.Two-way referral for patients with cerebral hemorrhage can reduce their medical cost and promote their better rehabilitation.

Objective To investigate the pathologic base of breast cancer malignant halo.Methods The status of margin of 80 cases confirmed breast nonspecific invasive ductal cancer by pathology were determined preoperatively.80 cases were divided into two groups:malignant halo group and non malignant halo group.The estrogen receptor (ER),progesterone receptor (PR),human endothelial growth factor receptor (CerB-2),nuclear protein antibodies (Ki-67) expression were detected by immunohistochemical method.The histological grade,mitotic count and documented tumor size,patient age and the number of lymph node metastases,breast cancer margin on pathology were observed.Halo tissue were drawn from specimens and the tissue structure were observed.Results Ki-67 expression in malignant halo group were significantly lower than those in non malignant halo group.The observing results of the margin status of breast cancer on ultrasound and pathology were consistent.Halo tissue was mainly composed of fatty tissue and scattered clumps of cancerous tissue,fibrous tissue,normal lobular and tubular.Conclusions Malignant halo is a special manifestation of breast cancer on gray-scale ultrasound.

The article describes the current situation of training mode of community nurses in community health service institutions in Hubei province from several aspects,including training object,training target,training base,teaching staff,training organization and government,training method and time,training curriculum,training effect evaluation and certification.The article suggests a multitude of factors influencing the training quality,such as formal training,dominant job training,and monotonous community training content and less training time.Overall,the government should be done something to increase government support and funding and accelerate the community nursing services and community nursing education.It is also essential to establish community nursing personnel training mechanism,improve and perfect the community health personnel training system,increase the construction of community nursing practice base and facilities and strengthen clinical practice skills.

Objective:To sduty the effect of β-lactam antibiotics efiriaxone on the levels of glutamate and glutamate transporter subtype-1 in hippocampus following traumatic brain injury in rats.Methods: All rats were divided randomly into three groups:sham group;TBI group and CTX group.The rat model of TBI were made by modified Feeney method ,and treated with ceftriaxone immediately after injury ( 200 mg/kg ).Wet-dry weight method was used to evaluate brain edema.The content of glutamate in hippocampus was measured with the high performance liquid chromatography.The expression of GLT-1 in hippocampus areas was tested by immunohisto-chemical and Western blot methods.Results:Compared with TBI group ,TBI-induced cerebral edema was significantly attenuated ( P<0.05 ) , the content of glutamate in hippocampus was were significantly decreased ( P<0.05 ) , the level of GLT-1 were significantly increased in CTX group ( P<0.05 ).Conclusion: β-lactam antibiotics ceftriaxone can block the excitatory neurotoxicity , reduce the extent of brain edema.

Objective To study the correlation of posttraumatic growth with psychological resilience,social support and self-efficacy in breast cancer patients.Methods The questionnaires of Posttraumatic Growth Inventory (PTGI),Connor-Davidson Resilience Scale (CD-RISC),Perceived Social Support Scale (PSSS),General Self-Efficacy Scale (GSES) were used to measure 170 patients with breast cancer.Finally 159 questionnaires were returned.The investigation results were analyzed.Results Among 159 patients,the score of PTGI was (56.41±17.19) scores.The dimension score from high to low order were the relationships with others,personal strength,appreciation of life,new possibilities:(3.29±0.99),(3.19±1.00),(2.94±1.15),(2.36± 1.15) scores.The score of CD-RISC was (63.36± 14.43) scores,PSSS was (69.28±8.59) scores.The score of support from family was (24.45±3.67) scores,which was in the high level.The score of support out of family was (33.51±5.60) scores,which was in the medium level.The posttraumatic growth in breast cancer was positively correlated with the psychological resilience,perceived social support,support out of family,and general self-efficacy,P＜0.05.Conclusions The posttraumatic growth of patients with breast cancer is in the medium level,which still should be improved.The measures which can improve psychological resilience,social support,general self-efficacy of patients would also improve the posttraumatic growth in patients with breast cancer.

Objective To evaluate the in vivo efficacy of modified platelet(PLT) additive solution(PAS-ⅢM) with trehalose as a substitute for plasma for the storage of platelet concentrates at low temperature(10℃).Methods Rabbit platelet concentrates were collected and stored in different media and temperature conditions,plasma(22℃),70%PAS-ⅢM/30% plasma(10℃) and plasma/trehalose(-85℃).Platelets in plasma(22℃) on storage day 3,in 70%PAS-ⅢM/30% plasma(10℃) on storage day 3,7,9,and in plasma/trehalose(-85℃) thawed on day 20 were transfused to rabbit thrombocytopenia model.The in vivo recoveries and survivals of the three preserved platelets and fresh platelets were measured and evaluated after transfusion into rabit model of thrombocytopenia.Results The survival of platelets stored in 70% PAS-ⅢM/30% plasma(10℃) on day 9 was lower than that of fresh platelets(P0.05).Recovery and survival of frozen platelets were significant lower than those of the other groups(P

Objective To evaluate the short-term therapeutic effects for patients with primary liver cancer using three-dimensional stereotactic conformal radiotherapy(3D-CRT).Methods Twenty-eight patients with primary hepatic cancer were treated with 3D-CRT(the average overall dose was 38Gy,localized by Elscint twin flash slice CT,radiotherapy plan was designed by Leibinger three-dimensional radiotherapy planning system and operated on Varian 600C/D liner accelerator).The average follow-up time was 12 months(5-17mon.).Tumor volume response rate,rate of free from tumor progression and survival rate were analyzed.The adverse effects were studied simultaneously.Results According to follow-up CT results 3 months after radiotherapy,2 cases had full responses with disappearance of the tumors,while partial responses with decreased tumors mass were seen in 22 cases,and no response in 4 cases.Tumor volume response rate was 85.7%.The last follow-up CT results showed that in 5 patients there was tumor progression in planning target volume(PTV),in 10 cases there was intrahepatic progression but not in PTV,and in 4 cases extrahepatic tumor growth.Intrahepatic tumor free rates 6 months and 12 months after radiotherapy were 66.5% and 38.4%,respectively.6-month survival rate after radiotherapy was 88.6%,12-month survival rate was 70.5% after radiotherapy.During 3 months of radiotherapy,manifestations of subacute radiation injuries occurred in six patients:gastrointestinal hemorrhage in 2 cases,jaundice in 3 cases and subacute radiation hepatitis in 1 patient.No survivors suffered from long-term liver injury.Conclusions With little adverse effect,3D-CRT could raise the control rate of the hepatic tumor,and also short-term survival rate.There fore,3D-CRT is a valuable treatment for patients with primary liver cancer.