Hedging is an important component of vague language. This paper retrieves high frequency expressions of hedgingby using medical English corpus. Pragmatic functions of hedging are analyzed, which can be summarized as politeness principle, authors' self-protection, avoidance of the absolute, pursuit of objectiveness as well as conversational implication. To medical researchers, it is necessary to cultivate the awareness of hedging and learn how to adopt it in their research papers.

Objective:To explore the clinical application of permanent needle of deep venipuncture in early management of extensive burn.Methods:88 patients with extensively burn are analyzed.Results:The success rate of venipuncture was 96%.The effect was satisfactory,while the complication was less.Conclusion:The permanent needle of deep venipuncture shows an important role in early management of extensive burn.

ObjectiveTo investigate the risk factors,prevention measures and treatment methods of the pulmonary fibrosis patients with nosocomial pulmonary fungal infection. Methods50 pulmonary fibrosis patients with nosocomial pulmonary fungal infection were chosen as the observation group. In the same time,50 pulmonary fibrosis patients without nosocomial pulmonary fungal infection were chosen as the control group. The following factors were compared: hospital stay, corticosteroid use, antibiotic use, invasive procedures, a merger of the underlying disease.ResultsThere were 46％ (23/50) patients had long-term use of antibiotics in the observation group, much more than the control group(26％ ,13/50) ,the difference was statistically significant( P ＜0.05) ;More than half of patients in both groups using glucocorticoids, the ratio in the observation group was 84％ (42/50), which was significantly higher than the control group( P ＜ 0.05) ; In the observation group, the rates of patients with long time hospitalization ( ≥30 days), received invasive procedures, and associated with underlying diseases were much higher than the control group( all P ＜ 0.05). ConclusionMultiple risk factors could lead to the occurrence of pulmonary fibrosis patients with nosocomial pulmonary fungal infection,and the positive and effective preventions and standard treatment should be taken.

Primary central nervous system lymphoma (PCNSL) is a rare type of extranodal lymphoma, and its incidence rate is increasing nowadays. Chemotherapy is the main means for treatment of PCNSL and the efficacy of high-dose methotrexate (HD-MTX) has been confirmed among those chemotherapeutics. Treatments of HD-MTX combined with other drugs have been studied extensively. Progress of HD-MTX and other drugs for PCNSL are reviewed in this article.

The prognosis of patients with pancreatic cancer is dismal, especially at the advanced stage of the disease. Surgery is considered as the only curative treatment modality for pancreatic cancer;however, less than 20% of patients are candidates for curative surgical resection. Multidisciplinary management, including radiation therapy with concurrent chemotherapy, followed by systemic chemotherapy, is the treatment of choice for locally advanced pancreatic cancer. An early phase Ⅲ clinical trial conducted by GITSG (GI Tumor Study Group) has demonstrated a survival benefit for concurrent chemoradiation as compared to radiation alone in locally advanced disease. 5-FU,capacitabine and gemcitabine are the most investigated chemotherapy agents used with radiation. Currently thecombined use of gemcitabine and radiation therapy is under active investigation, and may provide substantial clinical advantage over other regimens. Multi-agent chemotherapy regimen used in concurrence with radiation has not demonstrated any significant effect but with severe toxicities. Conformal radiotherapy should be routinely used to treat locally advanced pancreatic cancer with doses of 45-50.4 Gy. The target of locally advanced pancreatic cancer is focussed on the gross tumor with safe margins. The use of IMRT is highly recommended for unresectable tumor, and makes further dose escalation possible.

Objective To analyze the prevalence of lower urinary tract dysfunction in stroke patients in the convalescent stage,its risk factors and the characteristics of urodynamics.Methods One hundred and thirty-one stroke patients in the convalescent stage were included in this study.Their general information,neurological system reviewing and past history were obtained,especially detailed micturitional histories.In patients with urinary symptoms,diagnosis and classification were made and relevant analysis and urodynamic study were performed.Results The prevalence of lower urinary tract dysfunction is 44.3%.The most common symptom was urinary incontinence(frequency,urgency and nocturia)followed by hesitancy,straining and urinary retention.The incidence of micturitional disturbance is higher 1.8 times in cognitive disfunction group than normal cognitive function group(χ~2=18.683,P=0.000);it was higher 1.2 times in patients with modified Bathel index scale≤20 than those with≥25(χ~2=16.832,P=0.000).Logistic multivariate analyses suggested that age(OR=1.622,95%CI 1.183-2.224),the during of urethral catheterization(OR=3.236,95%CI 1.335-7.840)and single or multiple lesions (OR=1.296.95%CI 1.083-1.550)to be the risk factors of lower urinary tract dysfunction at the convalescent stage in stroke patients.The urodynamics study found detrusor over activity in 78.5% patients,normal in 10.5%and detrusor areflexia in 10.5% patients.There was no detrusor-sphincter dyssynergia.Conclusions Lower urinary tract dysfunction is common after stroke with the storage symptoms to be the most common.Patients with lower urinary tract dysfunction show impaired cognitive function and poor ability in daily life.Age,during of urethral catheterization and single or multiple lesions are among risk factors of lower urinary tract dysfunction.Detruser overactivity is the most common finding in urodynamic study.Because the clinic symptoms are not often in accordance with the findings in urodynamics study,further urodynamics study are needed to benefit the treatment.

Objective To explore the role of myofibroblasts expressing α-smooth muscle actin (a-SMA) in hyperplastic scar formation.Methods Expression of α-SMA in normal skin and scar was examined by means of immunohistochemistry.The contents of myofibroblasts were measured and com-pared with that of hydroxyproline through cell culture.The contents of precollagen (pc β) , transforming growth factor β (TGF-β) and fibronectin in fibroblasts and myofibroblasts were assayed by ELISA.Results Vascular smooth muscle cells rather than other hypodermal cells expressed α-SMA in normal skin (P<0.01).The expression ofa-SMA was markedly increased up to 96.89% in hyperplastic scar tissues, with statistical difference compared with normal skin (P < 0.01).The contents of hydroxyproline (P <0.01) , pc (P <0.05) , TGF-β (P <0.01) and fibronectin (P <0.05) in myofibroblasts were significantly higher than those in fibroblasts.Conclusion Myofibroblasts play a key role in formation of hypertrophic scar.

Objective To estimate the curative effect and cost-effectiveness of moxifloxacin and gatifloxacin for treatment of urinary traet infection. Methods Eighty patients with urinary tract infection were randomly divided into treatment group (40 cases) and control group (40 cases). The patients in treatment group were given 400 mg moxifloxacin once a day for 7 d, while in control group were given 400 mg gatifloxacin once a day for 7d. Results The total clinical effective rate of treatment group and control group were 95.0%(38/40) and 92.5%(37/40) respectively, and the bacterial eliminating rate were 77.50% (31/40) and 76.92% (30/39), and the rate of adverse reaction were 5.0% ( 2/40 ) and 7.5% (3/40) respectively. There was no significant difference between two groups (P>0.05). The cost-effectiveness ratio of moxifloxacin was 2296 and 779 for gatifloxacin (P<0.01). Conclusion The therapeutic scheme of gatifloxacin seems to be the best one for treating urinary tract infection.

AIM　To improve the treatmemt efficacy and reduce the side effect of carboplatin (CBP), the antitumor drug was incorporated into niosomes (NS). METHODS　Lung targeted niosomes of CBP (CBP-NS) were prepared by the method of hand shaking. The ultraviolet absorption spectrophotometric method was used for the determination of CBP. The method of dynamic dialysis was used for in vitro release of CBP from CBP-NS. The S-180 lung neoplasms models were established by iv cancer cells in mice. The number of pulmonary nodules was examined for evaluating the therapeutic efficacy. RESULTS　The data showed that the mean diameter of CBP-NS was 3.72 μm, with a span of 0.66. The entrapment ratio of CBP in CBP-NS was 29.2% and the CBP-NS were stable for three months stored at 3℃-5℃, 15℃-25℃ or 37℃ (relative humidity 75%). The release profile in vitro could be described by a biexpotential equation. The calculated values of the three targeting parameters indicated that CBP-NS showed good targeting efficiency. The results of therapeutic trials showed that the antitumor effects were significantly increased by injection of CBP-NS compared with CBP in the treatment of mice with lung carcinoma. CONCLUSION　The results indicated that CBP-NS have good targeting efficiency in vivo, and the biodegradable CBP-NS may decrease the side effects of carboplatin and improve its therapeutic efficacy.

Acadamy is the basis of discipline construction,and the public trust is the life of academy.However,the decline of public trust has become prominent in our science field.This paper is aimed at revealing the potential factors for the decline,and to propose measures to counteract them,so as to to remodel the public trust in academia.