Objective To investigate the CR low dose radiography to COPD in patients with pseudo normal phenomenon.Methods 160 cases of COPD diagnosed,stratified random dividing method according to the pulmonary function test values were divided into A,B,C and D group.Each group had 32 cases,at the same time,the increase in lung function in patients with mild to moderate pulmonary emphysema in 32 cases was E group,wich was treated with normal dose as a control group,in the normal dose and low dose CR photography failed to clear the diagnosis of emphysema,causing false normalization,statistical the case number,and verify the pulmonary function classification criteria,identify false normalization of lesions in such a case,the general rule to judge the feasibility analysis and prevention.Results There was no significant chifference among 5 groups of pseudo normal comparison (x2 =4.56,P ＞0.05).Conclusion Chronic obstructive pulmonary disease with low dose CR photography on severe and extremely severe patients is deteded by emphysema detection with rate high.Moderate,mild COPD detection rate is extremely low.

Objective To analyze the effect of a new model in the nursing care ward round in the hand surgery department.Methods The implementation of nursing care ward round in the hand surgery department was retrospectively analyzed.Results The comprehensive quality of nurses were increased obviously when the new model ward round was implemented.Patients were more satisfied with the work of nursing care.The evaluation of new model ward round by nurses was higher than before.Conclusions The new model of nursing ward round showed a great help for increasing the comprehensive quality of nurses,the responsibility awareness of nurses and the nursing quality.It presented an significant application value by developing new nursing care technique and helping establish harmonious relationship between the nursing staff and patients.

ObjectiveTo observe the turnover of impaired glucose tolerance(IGT)patients intervened with different measures.MethodsIGT 158 patients found by physical examination in the community residents were randomly divided into health education group,Chinese medicine group,and western medicine group,and treated with health education,traditional Chinese medicine and western medicine respectively.The fasting blood glucose,oral glucose after 2hour blood glucose (2hPG),serum lipid,glycosylated hemoglobin index were observed.ResultsThe efficiency of patients with IGT was 48.0％,70.3％ and 75.0％ in health education group,Chinese medicine and western medicine respectively.There was significant difference of therapeutic effect between the western medicine group and health education group (x2=7.96,P＜0.05),and between the traditional Chinese medicine group and health education group (x2=5.46,P＜0.05),while there was no significant difference between the traditional Chinese medicine group and Western medicine group (x2 =2.31,P＞0.05).ConclusionTraditional Chinese medicine and Western Medicine both have good effects on patients with IGT.But due to its good tolerability and few side effect,TCM may be more easily accepted by patients.

Objective To study effects of high dosage of atorvastatin in acute coronary syndrome(ACS)patients on high sensitive creactive protein(hsCRP)and atherosclerosis.Methods 126 cases with ACS were divided into A,B and C group.30 patients in A group were given atorvastatin 20mg per night,41 cases in B group were given atorvastatin 40mg per night,while the other 55 patients in C group were taken atorvastatin 40mg per night and tirofiban in the first 24 to 48 hours.The patients were followed 6 months by evaluating serum hsCRP concentration,measuring the intimal thickness in the carotid artery with color Doppler.Results After treatment for 6 months,the patients in the three groups showed significant decrease in hsCRP,however,the therapeutic group showed significant difference amony the three groups.Additionally,the B and C groups further showed significant decrease in intimal thickness.Conclusion Using high-dose atorvastatin and tirofiban not only lowers hsCRP significantly,but also benefit stability of atherosclerotic plaque in carotid artery,and to reduce cardiovascular events.

Objective To explore the application of multislice computed tomographyic ( MSCT) perfusion imaging in the assessment of acute cerebral infarction. Methods 50 patients who initially diagnosed as acute cerebral infarction in 6 hours after their outbreak of infarction were selected. The Siemens semsation 4 MSCT was used to scan the patients and form time versus concentration curve analysis, including the comparision of region cerebral blood flow (CBF) between the necrosis region and the normal region, region cerebral blood volume (CBV), mean transit time ( MTT). Each case had to be examined by computed tomography at least once a week after infarction. Results 50 patients were found having a lower CBF and CBV in their necrosis region compared with the other side(P＜0.05) ,and had a longer MTT in their necrosis region compared with the other side( P ＜0.05) ,45 patients were observed a shrink of the size of the infarction region compared with the perfusion image in first 6 hours when they were reexamined by CT a week later(P ＜0.05) ,which proved the exist of ischemic penumbra area around the infarction center. Conclusion The multislice computed tomographyic perfusion imaging technology could define the infarction region and size at the early stage of acute cerebral infarction. It also provided clues to indicate the exist of a vascular area around the necrosis centre. It could diagnose acute cerebral infarction at hyperacute period and provide image proof for the thrombolysis in early period and treatment in individual manner.

This paper took the charity culture cultivation system of the medical university as the research ob-ject, used the method of empirical research , illustrate how to build the charity culture educational system based on the practice of charitable culture education in Wenzhou medical university .The following:imparting charity culture knowledge , setting up the concept of charity;carrying out thematic education activity , cultivating gratitude;carry-ing out community volunteer service , creating the atmosphere of charity;creating charitable culture brand , building a charity culture education platform were discussed .Furthermore , the practice effect of the charity culture cultiva-tion system was also discussed from educating students , campus culture and promoting social morality .

Objective To investigate the effect of levocarnitine ane hemoperfusion on micro-inflammatory state of maintenance hemoeialysis patients. Methods Ninety-nine hemoeialysis patients were selectee as our subjects who hospitalizee from Jan. 2006 to Jan. 2013 in Provincial Hospital Affiliatee to Shaneong University ane were raneomly eivieee into A,B ane C groups. Thirty-three patients in A group were treatee with hemoperfusion combinee with L-carnitine therapy,33 cases in B group were appliee hemoperfusion ane 30 cases in C group were treatee with oreinary eialysis. The level of high sensitivity C reactionprotein( hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)were measuree at before treatment,1ane 6 months after treatment. Results The levels of IL-6 in A group at before treatment,1 ane 6 months were(( 77. 53 ±12. 64),(62. 17 ± 11. 09),(42. 76 ± 10. 22))ng/L respectively,ane those were((76. 13 ± 13. 46), (70. 07 ± 2. 54),(59. 35 ± 11. 21))ng/L respectively in B group ane((78. 10 ± 10. 74),(72. 81 ± 11. 73), (68. 11 ± 13. 53))ng/L respectively in C group. The eifferences were significant( F within group=11. 642,P<0. 01;F among groups=6. 341,P<0. 01,F interaction=18. 275,P<0. 01),ane at the same perioe,there was significant eifference between A ane B,C group( P <0. 05 ). The levels of TNF-α in A group at before treatment,1 ane 6 months were((43. 59 ± 9. 81),(32. 34 ± 8. 68),(25. 7 ± 71. 27))ng/L respectively,ane those were((44. 53 ± 8. 62),(39. 15 ± 9. 72),(34. 82 ± 7. 21))ng/L respectively in B group ane((42. 19 ± 6. 72),(38. 63 ± 7. 65),(36. 98 ± 5. 89))ng/L respectively in C group. The eifferences among 3 groups were significant( F within groups = 10. 630,P < 0. 01;F among groups = 6. 654,P < 0. 01;F interaction=18. 273,P<0. 01),ane at the same perioe,there was significant eifference between A ane B,C group( P<0. 05). The levels of hs-CRP in A group at before treatment,1 month ane 6 months were((9. 34 ± 1. 16), (7. 28 ± 1. 05)ane(5. 13 ± 0. 84))mg/L. Those were((9. 05 ± 1. 36),(7. 97 ± 1. 08),(5. 82 ± 1. 13))mg/L in B group ane((9. 25 ± 1. 34),(8. 83 ± 1. 12),(8. 56 ± 1. 08))mg/L in C group. The eifferences among three groups were significant( F within group=12. 002,P<0. 01;F among groups=6. 681,P<0. 01;F interaction=17. 753,P<0. 01). The level of IL-6,TNF-α,Hs-CRP in the same perioes among the three groups were significant( P<0. 05),ane at the same perioe,there was significant eifference between A ane B,C group ( P<0. 05). Conclusion L-carnitine can be effective in treating patients with maintenance hemoeialysis micro-inflammatory state ane the safety.

Objective To explore the relationships between antithrombinⅢ(AT-Ⅲ) and D-dimer (DD) level with pediat-ric critical illness score (PCIS) in children with sepsis, and to evaluate the values in assessing the severity of illness. Methods Sixty-one children with sepsis were included in this study. Within 24 hours after admission, blood samples were tested for the ac-tivity of AT-Ⅲ and DD level. The PCIS was calculated. According to PCIS, the patients were divided into extremely critical group (<70), critical group (71-80) and non-critical group (80-100). According to the prognosis, the patients were divided into survival and death groups. The differences of the activity of AT-Ⅲand DD were compared and the relationship with PCIS were analyzed. Results The activity of AT-Ⅲ was lower and DD level was higher in critical group than in non-critical group (P<0.01) and the changes in extremely critical group were more evident than those in critical group. The activity of AT-Ⅲand PCIS were positively correlated (r=0.548, P<0.01).The DD level and PCIS was negatively correlated (r=-0.657, P<0.01). Compared with survival group, the level of DD was significantly higher in death group (P<0.01), and PCIS and the activity of AT-Ⅲwere significantly lower in death group (P<0.05). Conclusions The patients with sepsis have dysfunctions of coagulation. The activity of AT-Ⅲ, DD level are correlated with illness severity, and can be useful for assessing the severity of sepsis.

Objective To study the relation of the variations of serum neuron-specific enolase (NSE) level and brain damage in asphyxia neonatorum.Methods The serum NSE level were detected in 75 asphyxia neonatorum(asphyxia group) and 20 normal neonatorum(control group) by the method of ELISA after parturition 1,3 and 7 d.The relation of serum NSE level and brain damage was analyzed.Results After parturition 1,3 and 7 d,the serum NSE level in mild asphyxia group and severe asphyxia group was higher than that in control group [(29.85 ±8.53),(59.26 ± 15.75) μg/L vs.(15.59 ±6.25) μg/L; (23.69 ± 6.54),(47.28 ±12.46) μg/L vs.(15.38 ±5.84) μg/L; (18.95 ±5.37),(62.57 ±19.62) μg/L vs.(13.92 ±5.37) μg/L],and the serum NSE level in sever asphyxia group was higher than that in mild asphyxia group,there had significantly difference (P＜ 0.05).After parturition 1,3 and 7 d,the serum NSE level in brain damage neonatorum (25 cases) was increased and in CT normal neonatorum (50 cases) was decreased,the serum NSE level in brain damage neonatorum was higher than that in CT normal neonatorum [(37.48 ± 12.09) μg/L vs.(30.95 ± 11.86) μg/L,(51.84 ± 14.21) μg/L vs.(21.73 ±6.15) μg/L,(68.25 ± 18.69) μ g/L vs.(15.62 ± 5.94) μ g/L],there had significantly difference (P ＜ 0.05).Conclusion The variations of serum NSE level can be the important indicator to monitor brain damage in asphyxia neonatorum.

Objective To investigate the state of self-perceived burden (SPB) and depression and to explore the relationship between them for patients with chronic respiratory diseases.Methods 95 patients with chronic respiratory diseases were investigated by the Self-Perceived Burden Scale (SPBS) and Self-Rating Depression Scale (SDS).Results The average score of SPBS was (33.64±10.23) points,which was at the middle level,90.5％ of patients showed different levels of burden,and 34.7％ of patients were at the high level.The average score of SDS was (50.23±11.93),the index was 0.63,which was at the middle to high level,74.7％ of patients showed different levels of depression,and 33.7％ of patients were at the high level.There was a positive conrelation between SPB and depression.Conclusions Patients with chronic respiratory diseases had obvious SPB and depression,and there was a close relationship between them.With chronic respiratory diseases breaking out repeatedly and more severe year by year,most patients have high level of burden and negative emotions.Nurses should take proper measures and psychological interventions to help patients face to the diseases optimistically,and to improve patients' emotion state and enhance their physical and mental health.