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.

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.

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.

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.

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.

Objective To investigate midwives' role cognition and their working experience.Methods It was a qualitative study using the phenomenological method.10 midwives were interviewed and all the data were analyzed using the categorization method.Results Three main categories were identified:diversified midwife roles; capacities and qualities required to fulfill midwifery roles; positive and negative experiences coexisted.Conclusions Managers should develop humanized management approaches to facilitate the fulfillment of midwives' roles and improve their working experience.The research also revealed the need to improve Chinese midwifery education and the midwifery regulation systems.

Objective To study the treatment effect of rivet with thread,instead of clavicular hook plate,for Tossy Ⅱ & Ⅲ dislocation of acromioclavicular joint.Methods From January 2008 to February 2009,totally 31 patients with Tossy Ⅱ or Ⅲ dislocation of acromioclavicular joint were treated using rivets with thread,including 19 males and 12 females at the age of 33-49 years(mean,41 years).Among these patients,19 suffered fresh acromioclavicular joint dislocation,9 suffered old acromioclavicular joint dislocation,and 3 did a failed fixation by clavicular hook plate.None of them was combined fracture.Mitek 3.0 mm rivet with thread was embedded to coracoid,with nonabsorbable thread connected with the rivet passing through the clavicle for fixation,and meanwhile ligament coracoclaviculare was restored or acromiocoracoid ligament displaced.Among them,12 patients assisted Kieschner wire fixation.The treatment effect was evaluated using Japanese Orthopaedic Association(JOA)scoring system and acromioclavicular joint dislocation scoring system.Results All patients were followed up 11-23 months(mean,17 months).In the patients without Kieschner wire fixation,JOA shoulder score was 65-95,excellent for 8 cases,good for 9,fine for 1,poor for 1,excellent and good rate was 89.47%(17/19);In the patients with Kieschner wire assisted fixation,JOA shoulder score was 74-97,excellent for 5,good for 4,fine for 3; the excellent and good rate was 75.00%(9/12).With acromioclavicular joint dislocation scoring system,the overall excellent and good rate was 94.74%(18/19),and 91.67%(11/12)respectively.No complication that affected joint function was found.Conclusion Rivets with thread can be used for treating Tossy Ⅱ & Ⅲ dislocation of acromioclavicular joint.This surgical technique is characterized by small operation wound,fewer complications,no secondary operation,and satisfactory treatment effect.

Viral myocarditis involving the cardiac conduction system is easily associated with a variety of arrhythmias. Negative inotropic effect and the potentially induced arrhythmia of antiarrhythmic drugs limit their application. Non-drug treatment with the body injuries and high medical costs holds patients back and leads them to take a conservative treatment. Traditional medical treatment of this disease has a long history and rich experience. Clinical and experimental studies show that traditional Chinese medicine is effective and has few side effects. This article discusses the ideas of treatments of arrhythmia, from three aspects of differentiating diseases and syndrome type, dispelling wind-evil and dredging collaterals and using results of pharmacological researches reasonably.

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.