Objective To explore the fatigue in patients with rheumatic diseases and put forward nursing countermeasures.Methods 173 patients with rheumatic diseases were investigated by Fatigue Scale-14 (FS-14) and Self-rating Depression Scale (SDS).Results The score of physical fatigue,mental fatigue and total score in the patients were 5.03±2.19,2.62±1.56,7.65±3.03,respectively,which were higher than those in healthy people (P＜ 0.01).Of the 173 patients,74 (42.8％) patients suffered from physical fatigue,52 (30.1％) patients suffered from mental fatigue,32 (18.5％) patients suffered from both.There were statistical differences in the physical fatigue and total score (P ＜ 0.01),no statistical difference in the mental fatigue (P ＞ 0.05) among the groups,which were divided according to the course of disease.There were statistical differences in the physical fatigue,mental fatigue and total score among the groups,which were divided according to the depression index (F=5.28,5.98,8.58,P ＜ 0.01).The regression analysis further showed the course of disease and depression index could positively predict the fatigue in patients with rheumatic diseases.Conclusions The prevalence of fatigue was high in patients with rheumatic diseases,the course of disease and depression influenced the fatigue in patients.Controlling deterioration of disease and relieving psychological stress would help prevent and alleviate the fatigue in patients with rheumatic diseases.

To evaluate percutaneous dilatational tracheostomy (PDT) with continuous aspiration of subglottic secretions in intensive care unit (ICU) elder patients.A total of 32 elder patients were selected randomly for PDT and 36 controls for traditional surgical tracheostomy (TST).The PDT group required regular mechanical ventilation with continuous aspiration of subglottic secretions.The operative duration was significantly shorter in PDT group than that in TST group [ ( 10.6 ±3.4)vs.(30.9 ±7.1)min,P ＜0.01].Incision length was significantly less in PDT group than that in TST group [ ( 1.3 ± 0.2 ) vs.(3.2 ± 0.3 )cm,P ＜0.01].Blood loss volume was significantly less in PDT group than that in TST group [ ( 10.4 ±3.8 ) vs.(40.7 ± 11.7 ) ml,P ＜ 0.01].The incidence of ventilator associated pneumonia (VAP) was significantly lower in PDT group than that in TST group ( 15.6％ vs.38.9％,P ＜ 0.05 ).With multiple advantages of mini-invasiveness,safety,simplicity,convenience and easier installation,PDT is quite suitable for elder patients in ICU.

Objective:To explain the supplier induced demand theory paradigm,track the empirical research progress,so as to provide references for health care reform in China.Methods:The new classical theory,game theory and behaviorism school were launched to process theoretical derivation of induced demand.The classical empirical research and the latest research progress were introduced to systemically review on supplier induced demand.Results:The generation of supplier induced demand was related with incentive system,the type of diseases and the crowd of research.Conclusion:It could effectively reduce the induced demand for health care that constraining hospital internal incentive,conducting medical supply side structural reform,developing the “Internet +medical” and building Diagnosis Related Groups (DRGs) payment system.

Cellular signal transduction plays an important role in pathogenesis of myocardial ischemia reperfusion(MIR) injury. During this process, extracellular signal molecules, membrance receptors and intracellular signal paths are involved. There are many cross talkings in signal pathways at many levels. The present article reviews cellular signal transduction mechanisms in MIR. The exploration of MIR's cellular pathogenesis may be beneficial for us to prevent and cure the heart damage in clinic. Furthermore, it may provide a new way of thinking in mechanism research of medicine.

Objective:To investigate the clinical effect of Pijiling Liniment for seborrheic dermatosis on 327 cases. Methods:327 patients with seborrheic dermatosis were treated with Pijiling Liniment. The clinical effects were compared with that of the control group(Co.Resorcinol Ointment, 76 cases). Results:The total effective rate and curative rate of the treatment group for seborrheic dermatitis were 93.5% and 33.3%, respectively. The effective rate for acne was 80.6% and for dermatomycosis microsporina was 7.5%. The total effective rate and curative rate of the control group were 92.1% and 2.6 %, respectively. Conclusions:There is a significant difference in the curative rate between two groups( P 0.05) through x 2 test.

Objective To investigate clinical effect of surgical treatment for spinal stenosis with lumbar degenerative de novo scoliosis with spinal stenosis.To discuss selection of operation methods and ranges of fusion.Methods 27 patients of degenerative scoliosis with spinal stenosis were treated by oper-ation.We performed posterior decompression on the segments and selected fusion,then performed correc-tion deformity.Measured Cobb 's angle,lumbar lordosis angle,the distance between C7 plumb line (C7PL),upper edge of S1 vertebral body(SVA),and the distance between C7PL and center sacral verti-cal line(CVA)after operation and final follow up were compared with preoperative data.JOA score system were used to evaluate clinical effects.The SF-36 questionary was used to evaluate the patients'life quality before and after operation as well.Results All patients were followed up with an average of 20 months. Preoperative,postoperative and final follow up,Cobb's angle was(22.1 ±10.5 )°,(10.2 ±7.3)°and (10.4 ±4.8)°,respectively;lumbar lordosis angle was(21.2 ±10.3)°,(25.7 ±12.2)°and(25.3 ± 12.3)°,respectively;SVA was(7.5 ±6.1)cm,(0.6 ±3.1)cm and(0.5 ±2.4)cm,respectively;CVA was(6.9 ±5.3)cm,(2.8 ±1.3)cm and(2.9 ±1.2)cm,respectively.There was significant difference in data before and after operation(P >0.05).JOA score was 10.8 ±1.4,21.3 ±2.4 and 23.5 ±2.3,re-spectively;All domains of SF-36 score were significantly improved postoperatively(P <0.05).Conclu-sion For surgical treatment with limited decompression,pedicle screw fixation and fusion will be effective methods for degenerative scoliosis with spinal stenosis,individualized surgery design should be made ac-cording to clinical symptoms,signs and imaging features.

[Objective]Summary of the experience of Professor LIU Wenqiong in the treatment of leukoplakia vulvae of the aged.[Method]By using the method of the collection and collation of Professor LIU Wenqiong in the treatment of elderly patients with leukoplakia vulvae case,and combination with the related discussion of ancient.This paper summarizes the experience of Professor Liu in the treatment of leukoplakia vulvae of the aged from the etiology and pathogenesis,treatment based on syndrome differentiation,prescriptions and so on,and for proven cases.[Results]Professor LIU Wenqiong thinks that the root of the disease is mainly characterized by the dysfunction of Zang Fu organs and deficiency of qi and blood,the brounch of the disease is characterized by endogenous wind disturbance.Organs are mainly related to liver and kidney.The type of syndrome is yin deficiency of liver and kidney and blood deficiency and wind dryness.The treatment is mainly nourishing liver kidney yin,followed by eliminating wind and relieving itching,and combinating with traditional Chinese external washing medicine for local administration.It lists a successful case,and reflects that Professor LIU Wenqiong has great skill to make prescription accuratedly.Effect is significant.[Conclusion] The clinical experience of Professor LIU Wenqiong in treatment of leukoplakia vulvae is effective,and she provides ideas and methods for the treatment of this discase,which has the value of popularization and application in clinical practice.

Emodin is the main effective monomer of Rhubarb, which has a variety of pharmacological actions and valuable clinical applications.Recently, there are many reports about molecular mechanisms of emodin pharmacological actions,and they givehighly attention on the dephlogisticating and antineoplastic effects. These effects are achieved through affecting the concentration and transportation of ions, resisting of oxidation and free radical, and affecting the secretion of inflammatory factor and the enzyme activity and apoptosis and so on. This article summarizes the reports and hopes to provide theoretical basis for the practical application.

Hydrocephalus is a common disease caused by the disorder of the physiological metabolism of cerebrospinal fluid.The damage mechanism is abnormal expansion of the ventricular system and impairment to the surrounding brain tissue.Hydrocephalus in children can show individual clinical symptoms along with the age of onset and different causes,leading to brain growth retardation.It is particularly important to understand its pathogenesis and etiology and put forward targeted treatment strategies by early diagnosis.This paper reviews the pathophysiology,etiology and characteristic manifestations of hydrocephalus in children.

Objective To evaluate the impact of integrated information management platform on life style of diabetic patients. Methods A total of 84 diabetic patients were assigned to the intervention group and the control group by random digits table method with 42 cases each. All patients were in the hospital and after discharge given conventional three-tier management model. The intervention group was given comprehensive information management platform, three-tier management model mediated on this basis. The life style, fasting blood glucose, glycated hemoglobin were collected and compared between the two groups before and after intervention. Results After 9 months of intervention, the dietary pattern of the intervention group was more in line with the Chinese Dietetic Association's recommended dietary standard, in which staple food decreased from (343.90 ± 225.61) g before intervention to (311.71 ± 144.46) g, and meat decreased from (61.52 ± 59.73) g before intervention to (50.07 ± 36.16) g, and the lipid content decreased from (32.67 ± 21.31) g before intervention to (28.57 ± 19.52) g, compared with the control group (376.49 ± 129.58), (73.90 ± 55.15), (45.78 ± 20.03) g, there were significant differences(t =2.076, 2.278, 3.841, all P<0.05). The number of physical exercises increased from 30 before intervention to 37 cases, the number of moderate exercise increased from 12 cases before intervention to 20 cases, and the median of exercise scores increased from 11.000 (26.500) points before intervention to 33.000 (23.500) points, compared with the control group 15.000(18.000) points, there was significant differences (Z =3.687, P<0.01). The fasting blood glucose, glycated hemoglobin were (7.73 ± 1.31) mmol/L, (6.75 ±1.81)% after intervention and 8.000(2.200) mmol/L, 7.600(1.600)%before intervention in the intervention group, compared with the control group (8.60 ± 2.25) mmol/L, (8.81 ± 2.63)%, there were significant differences(t =2.111, 4.062, P<0.05 or 0.01). Conclusions Integrated information management platform management mode three-mediated diabetes may urge to improve the existing way of life, better control of blood sugar.