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

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.

The current situation is that the study of blood system diseases is difficult, and the students lack both the initiative and enthusiasm to learn. Clinical teachers' energy is limited because of other clini-cal, management and research roles, so the quality of teaching varies greatly. Meanwhile, teaching quality has nothing to do with personal reviews. Furthermore, the relationship between doctors and patients is in trouble in current medical environment. All of these above affect the quality of clinical practice in hematology department. Aiming at these problems, we improve the teaching quality significantly by raising the students' interests, enhancing their initiative, improving teachers' teaching level and enthusiasm, carrying out the in-ternship system, and strictly enforce the elimination system.

Objective To characterize clinical features,antimicrobial susceptibility and the outcome of nosocomial Acinetobacter baumannii meningitis.Methods All patients with nosocomial meningitis due to Acinetobacter baumannii in 2nd Affiliated Hospital Medical School of Zhejiang University between January 2010 and October 2011 were retrospectively reviewed.Results During the study period,40 patients of this nosocomial infection were identified,who came from neurosurgery ward (19 cases,47.5％),neurosurgieal intensive care unit (18 cases,45.0％),emergency intensive care unit (2 cases,5.0％) or intensive care unit (1 case,2.5％).All the patients had a history of recent neurosurgical procedures. Fever and disturbance of consciousness were the major manifestations,and cerebrospinal fluid examination showed elevated white blood ceil count and protein,and reduced glucose.All isolated pathogens were resistant to the first line antibiotics.The fatality rate was high. Conclusions The most common risk factor for nosocomial Acinetobacter baumannii meningitis is neurosurgery. Resistance to the first line antibiotics is common among all pathogens isolated.The prognosis of the meningitis is poor.

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.

Objective:To explore the prevalence of posttraumatic stress symptoms among preschool children and its related factors after the Ludian earthquake.Methods:A total of 62 children's guardians were visited.They were interviewed with the Posttraumatic Stress Disorder Semi-Structured Interview for Infants and the Young Children and the Child Behavior Checklist-Posttraumatic Stress Disorder scale (CBCL-PTSD) consisted of 15 items from the CBCL.All of the participantsresided in Longtoushan settlement and Longtoushan town (the epicenter).They were randomly visited from west to east in that region.Results:The rate of scored 9 (or more) on the CBCL-PTSD among children was 51.9％ (27/52) in 1-2 months after the earthquake.However,based on the Semi-Structured Interview,the rate of the children's posttraumatic stress symptoms was 26.9 ％ (14/52).The numbers of posttraumatic stress symptoms,intrusion symptoms,avoidance symptoms,hyperarousal symptoms,the new symptoms and the CBCL-PTSD scores were positively correlated (0.30-0.73,P ＜0.05),except the relation between intrusion symptoms and hyperarousal symptoms.The rate of intrusion symptoms was significant higher among those who experienced earthquake than those who didn't (96.2％ vs.60.0％,P ＜0.01).And the rate of intrusion symptoms was also higher among those who was injured during the earthquake than those who wasn't (100％ vs.84.6％,P ＜ 0.05).And the other symptoms were not difference in children under different conditions (P ＞ 0.005).Conclusion:The preschool children who experienced earthquake or were injured suffer more posttraumatic stress symptoms.

Objective:To explore the effect of Fitness Qigong(Yi Jinjing)exercise on blood lipid and free radical metabolism of the elder women.Methods:The subjects of this experiment were 64 elder women who were divided into 2 groups randomly:exercise group(34 cases)and control group(30 cases).The exercise group practiced 40-50min pre time,six times pre week for six months,and the control group had no exercise with collective or individual scheme.The indexes of TC,TG,HDL,LDL,SOD,GSH-Px and MDA of the elder women were measured before and after 6-month exercise.Results:After six months Yi Jinjing exercise,the exercise group showed increase in HDL(P0.05),increase in SOD and GSH-Px(P0.05).Conclusion:Fitness Qigong(Yi Jinjing)exercise had the positive effects on blood lipid metabolism,and can suppress lipid peroxidation and maintain high antioxidative capacity of elder female individuals.

The most Cytokines are found to be produced and functional in both of immune systemsand nervous system, which become a foundation of interaction between nervous and immune system.Macrophage and microglia may play an important role in the study of CNS injury and regeneration.