Objective To identify the conflict management strategies of staff nurses in Macau. Methods The Thomas -Kilmann Conflict Mode Instrument (TKI)was employed in the study to investigate the conflict management strategies of a convenience sample of 140 staff nurses who were pursuing a Bachelor of Science in Nursing (Supplementary) Programme in Macau. Results The most commonly used strategy by staff nurses in Macau for conflict management was accommodation, followed by avoidance, then compromise. In contrast, the least often used strategy was competition. Conclusions Chinese culture as well as nursing education background should be fully considered when developing the training plan of conflict man -agement strategies for staff nurses in Macau.

Objective To explore the trend of mortality and years of life lost due to Esophageal Cancer in residents in Tieling,so as to provide the basis data on preventing Esophageal cancer in Tieling.Methods The data of residents in Tieling dying of Esophageal cancer from 2007 to 2015 was collected and cleared up to calculate the evaluation indexes including the mortality rate,the average percentage change of mortality rate.GM(1,1) model was used to predict the future mortality.Results From 2007 to 2015,the Average Esophageal cancer Mortality Rate of in residents in Tieling was 5.26 per 100000 persons,and especially 1.95％ raised a year.The Mortality Rate would increase from 2016 to 2019.Conclusion Tieling Esophageal Cancer mortality rate is on the rise,especially for elder men more than 60.So that the proper prevention measures should be car ried and strengthened.

Objective To compare clinical efficacy between the situ secondary spleen pedicle amputation in laparoscopic splenectomy and open splenectomy for traumatic spleen rupture.Methods From January 2013 to June 2015 a total of 70 patients with splenic rupture undergoing splenectomy were devided into laparoscopic surgery (35 cases) and open surgery (35 cases) group.Clinical data included total intraoperative blood loss,the time spent on splenic artery ligation,total operation time,postoperative drainage volume,postoperative hemoglobin,platelet and albumin levels,time of anal exsufflation,hospital stay and postoperative complications.Results The average operation time in the OS group was shorter than that in LS group (P ＜ 0.05).However,LS group was better than the OS group in splenic artery ligation time,postoperative drainage volume,anus aerofluxus time,postoperative platelet count,postoperative albumin recovery,hospital stay and postoperative complications (all P ＜ 0.05).Conclusions The laparoscopic splenectomy by the amputation of in situ secondary spleen pedicle for traumatic spleen rupture has the advantages of a rapid recovery and a low postoperative complication.

China ; Congresses as Topic ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional

Objective This study aimed to investigate the incidence and the cause for duodenalbiliary reflux and reflux cholangitis after metallic stent placement in distal common bile duct Methods After percutaneous transhepatic bile duct puncture and biliary outside drainage was performed, 16 cases with malignant distal biliary stricture underwent metallic stent placement in distal common bile duct Before stent placement, the routine laboratory studies including leukocyte, neutrophil percentage and the levels of total bilirubin and direct bilirubin in blood were performed for all patients. Two to five days [ an average of (3.3 ±0. 9) days ] after stent implantation, the above indexes were tested again, and 1 ml of water containing 185 MBq of 99Tcm-DTPA was given orally before extubation, then 99Tcm radioactivity in the bile was detected 2 hours later. For the measurement data obtained from the experiment, t test or Wilcoxon signed rank test was adopted to compare them, and P ＜ 0. 05 was considered to be statistically different Results In 14 cases, radioactivity was successfully detected in the bile 2-5 days after stent implantation. Twelve of them was detected to have radioactivity in the bile 2 hours before extubation with duodenal-biliary reflux. The technetium count in the bile accounted for 1.82% of the total intake dose. There was no radioactivity in the bile in 2 cases. In 14 patients, there were no symptoms of cholangitis such as high fever, chills, increased jaundice, and so on after stent implantation. The mean of white blood cell count was (7.59 t2. 62) × 109/L, and the median of neutrophil percentage was 0. 74. Compared with those before stent implantation, the difference did not reach statistical significance ( t = 0. 423, Z = 1. 036, P ＞ 0. 05 ).After stent implantation, the median of total bilirubin and direct bilirubin were significantly lower, which were 92. 2 and 74. 3 μmol/L. Compared with those before stenting,the difference was statistically significant (Z= -3. 170, -3. 170, P ＜0.05). Conclusions There is a high incidence of duodenal-biliary reflux after stent implantation in distal common bile duct in the early stage. However, there is no simultaneous cholangitis caused by duodenal-biliary reflux.

OBJECTIVETo study the effect of Jingui Shenqi Pill (JSP) on morphology of spinal cell apoptosis in rats injured by 192Ir irradiation.

METHODSOne hundred and twenty rats were randomly divided into four groups: the model group, the JSP group, the prednisone group and the normal group. Corresponding pharmaceutics were given to rats once a day for 14 days respectively. Then except rats in the normal group, the others received 192Ir interstitial irradiation with the dosage of 22 Gy using back-fixing technology. The injured segments of spinal cord were taken out for HE staining, TUNEL examination and observation with electron microscope 8 hrs, 24 hrs and 4 weeks after irradiation.

RESULTSHE staining examination showed no obvious histological change in rats 8 and 24 hrs after irradiation, but pathological changes, as tissue rarefaction and hemorrhage did found in white matter of spinal cord shown by TUNEL 4 weeks later. Electron microscopic examination and TUNEL staining showed that as compared with the model group, the apoptotic index in the JSP and predinisone treated groups was significantly lower (P < 0.01) 8 hrs after radiation, but it showed insignificant difference between groups at the time points of 24 hrs and 4 weeks after radiation (P > 0.05).

CONCLUSIONJSP could act against apoptosis of gliocyte in spinal cord of rats in early stage after brachytherapy, indicating that JSP possessing a prednisone-like action.

Animals ; Apoptosis ; drug effects ; radiation effects ; Brachytherapy ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Iridium Radioisotopes ; Male ; Phytotherapy ; Radiation Injuries ; pathology ; Radiation-Protective Agents ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; pathology ; radiation effects

Objective To evaluate the clinical efficacy of multiple stents placement in the management of hilar cholangiocarcinoma,especially in the complex cases of which the hepatic ducts are invaded.Methods Forty-five consecutive patients with hilar cholangiocarcinoma were treated with percutaneous transhepatic placement of two or three self-expandable metallic endoprostheses.The cause of hilar obstructions in these patients were all cholangiocarcinoma,including Bismuth classification type Ⅱ(n 12 ),Ⅲa(n 17),Ⅲb(n 10),and Ⅳ(n 6).Two or 3 stents were placed in the configuration of T,Y or X over the strictures.Results Stent placement with 2 or 3 endoprostheses was successful in all patients.All patients showed significant decrease in serum bilirubin level.The mortality rate within 30 days of stent placement was 2.2%(1/45).The mean survival and stent patency times were 215.3 d(26— 516 d)and 181.5 d(26—473 d),respectively.Conclusion Deploying of multiple metallic stents is an effective method to treat complex hilar cholangiocarcinoma,especially for the cases of which hepatic ducts are invaded:the henatic ducts should be drained as much as nossible.

Objective To explore the method and value of percutanously interventional therapeusis for treatment of obstructive jaundice caused by hepatocellular carcinoma accompanied with bile duct thrombosis.Methods Sixteen cases with bile duct thrombosis proved by pathology and imaging examinations were retrospectively analyzed.According to the clinical symptoms, all the patients received percutaneous transhepatic biliary drainage (PTBD) including permanent external drainage, temporary internal drainage and implantation of covered stents.Serum total bilirubin (TBIL) after the interventional therapeusis were measured and compared with that before the treatments by t test to evaluate the efficacy of these treatments.The relief of clinical symptoms was also reviewed to evaluate the efficacy of these treatments.The patients were followed up within 2 years.Results The PTBD was successfully performed in 16 cases.Permanent external drainage, temporary internal drainage and implantation of covered stents were performed in 2 patients, 7 patients and 7 patients respectively.TBIL after the interventional therapy decreased significantly (t=7.366, P<0.01) to (161.2±80.5) μmol/L averagely from (261.9±77.2)μmol/L before the treatments.All the patients died before the end of followed-up.The average survival time was 204 days (30 to 391 d)and the median survival time was 200 days.Bleeding and infection were the main complications, which could be controlled successfully by routine treatments.Conclusion With high achievement ratio and good efficacy, percutanously interventional therapeusis are good choices for the treatments of obstructive jaundice due to bile duct thrombosis.

Objective To investigate the expression and significance of the endocrine gland-derived vascular endothelial growth factor (EG-VEGF) and vascular endothelial growth factor(VEGF) in adrenocortical lesions of primary aldosteronism. Methods The expressions of EG-VEGF, and VEGF were detected by immunohistochemistry and real-time fluorescence quantitative PCR in samples of 18 cases of adrenocortical adenoma, 6 adrenocortical hyperplasia, and 8 normal adrenal cortex. The correlation between the expressions of EG-VEGF, VEGF, and clinicopathological parameters was analyzed. Results The expression of EG-VEGF or VEGF in adrenocortical adenomas was higher than that in adrenocortical hyperplasia or normal adrenal cortex ( all P＜0. 05 ), and the expression of EG-VEGF or VEGF between adrenocortical hyperplasia samples and normal adrenal cortex samples was indistinctive. There was no statistically significant correlation between EG-VEGF or VEGF expression and sex, age, blood pressure, serum potassium, plasma renin activity, except in case of serum aldosterone( P＜0.05 ). A positive correlation between EG-VEGF and VEGF ( P＜0. 01 ) was found. Conclusions EG-VEGF and VEGF may play a significant role in the formation and development of adrenocortical tumors in primary aldosteronism.