Objective To discuss the responsibility and quality requirement of head nurses in nursing quality improvement in obstetrical and gynecological department.Methods The responsibility of head nurses in nursing quality improvement in obstetrical and gynecological department were investigated by carrying out surveys in patients of obstetrical and gynecological department.Results The quality of head nurses needed improvement and their responsibility required definitude,thus the satisfaction degree of patients and nursing quality can be improved.Conclusions Through this research,we find that the head nurses not only need good quality,but also should be given definite responsibility and certain service,supervising and management power,if so,they can fully exert their role in nursing work.

After the concept of Chinese PLA digital hospitals was described , the current situations in information construction of both Chinese PLA hospitals and local hospitals were comparatively analyzed , which displayed the di-rection of information construction for Chinese PLA digital hospitals, and some measures that should be taken for the construction of Chinese PLA digital hospitals were proposed .

Humans ; Motion Sickness ; diagnosis ; Travel

BACKGROUND: There have been some foreign studies on the general anatomy of meniscus, while domestic materials about adult normal meniscus are few.OBJECTIVE: To measure the various data of adult meniscus, so as to provide anatomical basis for clinical meniscal sport injury.DESIGN: Repetitive measurement design.SETTING: Department of Scientific Research, Chengdu Medical College.MATERIALS: This experiment was carried out in the Laboratory of Local Anatomy, Department of Human Anatomy, Chengdu Medical College during September 2003 to September 2005. Totally 94 adult knee joint samples, without any diseases were harvested from 94 patients, including 48 male and 46 female.METHODS: Skin of knee joint, subcutaneous tissue and muscle were removed. Tendon of musculus quadriceps fexoris was cut above the whirbone. Articular capsule was open, and incisions were made and prolonged to the posterior wall of articular capsule. Anterior and posterior cruciate ligaments were exposed and cut near the starting point of anterior cruciate ligaments. Fat pad of articular capsule was carefully cleaned. Various data of adult medial and lateral meniscus before and after ex vivo were measured up and down.MAIN OUTCOME MEASURES: Measurement before ex vivo: ① The largest sagittal diameter, the length of outer arc, the width of anterior angle, caudomedial part and posterior angel of medial meniscus. ②The largest sagittal diameter, the length of outer arc, the largest transverse diameter, aperture length ( distance between anterior and posterior angel border of lateral meniscus), the width of anterior angle, caudomedial part and posterior angle of the lateral meniscus. Measurement after exvivo: ①The largest sagittal diameter, the length of outer arc, the width of anterior angle, caudomedial part and posterior angel as well as the thickness of lateral border, center and free edge of anterior angle, caudomedial part and posterior angel of medial meniscus. ② The largest sagittal diameter, the length of outer arc, the largest transverse diameter,aperture length, the width of anterior angle, caudomedial part and posterior angel as well as the thickness of lateral border, center and free edge of anterior angle, caudomedial part and posterior angel of lateral meniscus. RESULTS: ①The measuring data of medial and lateral meniscus of female samples were a little smaller than those of male samples. The measuring results of medial and lateral meniscus of male samples were basically consistent with the observed results. ②The anterior angle, caudomedial part and posterior angle of medial and lateral meniscus were gradually thinned from lateral border to interior free edge, and they were filled in the plateau between medial or lateral condyles and tibia in wedge shape. ③ Medial meniscus presented "C" or crescent shape. An terior angle adhered to the anterior intercondylar fossa of tibia which located in the front of the attachment point of anterior cruciate ligament, and posterior angle adhered to posterior intercondylar fossa of tibia which located in the rear of posterior angle of lateral meniscus and in the anteriomedialis of the attachment point of posterior cruciate ligament; There was no obvious changes in the length of outer arc of medial meniscus be- fore ex vivo (t=1.98,P ＞ 0.05). ④The lateral meniscus presented "0" shape a little , and anterior angle adhered to the front part of nodus among condyles of tibia and the rear of anterior cruciate ligament, and the posterior angle adhered to the rear of lateral intercondylar tubercle which located in the front of attachment point of posterior angle of medial menisus; There were no obvious changes in the length of outer arc of lateral meniscus before and after ex vivo (t=0.61,P ＞ 0.05), but ob vious changes existed in the width of anterior angle, caudomedial part and posterior angel of medial meniscus (t=2.49,P ＜ 0.05). CONCLUSION: The obtained measuring data of meniscus provide referencing basis for clinical meniscal sport injury.

Objective To compare the results of TEOAE and DPOAE in the same population of normal newborns, to provide information on choosing appropriate screening tools.Methods A two-steps protocol was taken with the first screening during the first 48 to 72 hours of birth and rescreened from one to two months old if the newborns failed the first screening.For each step of screening, TEOAE and DPOAE were performed simultaneously using AccuScreen hearing screening instrument (Madsen-GN Otometrics, Taastrup, Denmark).A total of 1 062 normal newborns (F/M=508/554) delivered in Peking Union Medical College Hospital were enrolled in this research for the first screening.Infants who failed either TEOAE or DPOAE screening in the first screening were referred to a second screening.Among them, 135 performed both DPOAE and TEOAE in the second step.The newborns who failed the second screening would receive ABR when they were 3 months old.Results In the first screening,the failure rate for TEOAE was 11.0% (117/1 062) and 13.7% (145/1 062) for DPOAE.In the second screening step, the failure rates were 17.8% (24/135) and 20.7% (28/135) for TEOAE and DPOAE, respectively.Chi-square and Fisher's test showed that the failure rates of DPOAE were significant higher than TEOAE for both steps (P<0.001).The agreements between TEOAE and DPOAE were 96.0% and 95.6% for the first and second steps respectively, and the kappa values were 0.817 and 0.857.As to the average time taken to accomplish the screening for one ear, TEOAE was 24±25 s and DPOAE was 40±34 s during the first screening;in the rescreening, TEOAE was 52±41 s and DPOAE was 73±62 s.Paired-t tests showed that the differences between DPOAE and TEOAE testing time were statistically significant (P=0.000) in both screening steps.Finally, 7 newborns (10 ears) were diagnosed conductive hearing loss(except 1 ear was sensorineural hearing loss).Conclusion As a screening tool, TEOAE got lower refer rates and took less time than DPOAE implicating TEOAE a better screening tool for normal neonates.

Objective: To investigate the predictive value of protein C(PC) for long-term mortality of patients with community-acquired pneumonia(CAP). Methods: A total of 657 patients with CAP were enrolled in Taian Central Hospital from January 2011 to December 2011.The patients were divided into short-term group(≤30 days), medium-term group(>30~90 days) and long-term group(>90 days). PC, high sensitivity C-reactive protein(hs-CRP), procalcitonin(PCT), pneumonia severity index(PSI) score and CURB-65 score were measured at the time of admission.The ROC curve was used to evaluate the independent risk factors.The Kaplan-Meier survival function curve was used to analyze the difference of mortality between the short-term group and long-term group.Independent risk factors for CAP risk were analyzed by COX regression. Results: A total of 597 cases were followed up, there were 49 cases(8.09%) in the short-term group, 11 cases(1.84%) in the medium-term group, and 537 cases(89.93%) in the long-term group.The PC levels in the short-term group, medium-term group and long-term group were (32.2±10.6)%, (43.1±9.9)%, (69.6±23.0)%, respectively.The level of PC was significantly increased in the short-term group compared with the medium-term group and long-term group (short-term group vs.medium-term group, q=6.18, P<0.05, short-term group vs.long-term group, q=9.87, P<0.05). The hs-CRP levels in the short-term group, medium-term group and long-term group were (108.1±22.4)mg/L, (68.2±12.9)mg/L, (25.1±17.1)mg/L, respectively.The level of hs-CRP was significantly increased in the short-term group compared with the medium-term group and long-term group (short-term group vs.medium-term group, q=5.23, P<0.05, short-term group vs.long-term group, q=12.95, P<0.05). Meanwhile, PC showed higher accuracy(AUC, 0.889) than CURB-65(AUC, 0.828) and hs-CRP(AUC, 0.711) in the long-term group.The Kaplan-Meier survival function curve showed that the mortality rate was significantly higher in the high-value group compared with the low-value group(F=17.10, P<0.01). PC was an independent factor for long-term mortality and was associated with poorer survival by the COX regression analysis. Conclusion PC has a high predictive value for long-term mortality in CAP patients.

Objective The aim of this study was to investigate whether the addition of neoadjuvant chemoradiotherapy ( NACRT ) to surgery can improve outcomes better than neoadjuvant chemotherapy in terms of rate of R0 resection, pathological complete response ( pCR ) and side effects. Methods This exploratory study included primary gastric adenocarcinoma patients staged as clinical T4N0 or anyTN1-3. Intensity modulated radiotherapy was delivered of 40 to 50 Gy in 22 to 25 fractions,5 days/week.Concurrent chemotherapy regimens included S-1 or Capecitabine or a combination of Paclitaxel plus Carboplatin.Results Eleven eligible patients were enrolled. R0 and R2 resections were performed in 9 ( 9/11) and 1 patients, respectively.Peritoneal metastasis was found in 1 case during exploratory laparotomy.The pCR was observed in 1 patient with R0 resection ( 1/10 ) . Ten cases completed radiotherapy and 8 cases completed chemotherapy. Nausea ( 3/11 ) , vomit ( 2/11 ) and anorexia ( 2/11 ) were the most common Grade 3 toxicities. Conclusions NACRT showed an acceptable toxicity and promising activity in locally advanced gastric adenocarcinoma.

Objective To investigate the effects of different irradiation techniques on dose distribution in target volume and normal tissues after the radical surgery for gastroesophageal junction adenocarcinoma,and to provide the optimal regimen for clinical treatment.Methods A total of 9 patients with gastroesophageal junction adenocarcinoma who underwent radical esophagus-proximal gastrectomy or total gastrectomy were enrolled.The therapeutic regimens of five-field static intensity-modulated radiotherapy (IMRT),volumetric-modulated arc therapy (VMAT),and helical tomotherapy (HT) were designed for each patient,and the dose-volume histogram was used to evaluate the effects of different irradiation techniques on the conformity index (CI) and homogeneity index (HI) of target volume and the surrounding normal tissues. The prescribed dose was 45 Gy at 1.8 Gy/fraction.The patients received oral S-1 as concurrent chemotherapy at a dose of 80 mg/(m 2? d) twice a day during radiotherapy.Results Compared with IMRT and VMAT,HT had better CI and HI of the target volume,as well as a better protective effect on the intestinal tract and bone marrow.Compared with IMRT and HT,VMAT had a lower V20 and V30 for the left kidney and a lower V30 for the heart,while IMRT had lower V5 and V10 for both lungs;V20 and mean dose showed no significant differences between the three techniques.HT had the highest mean sub-field hop count,followed by IMRT and VMAT.Conclusions IMRT, VMAT, and HT can meet the clinical requirements,but besides ensuring the best CI and HI of the target volume,HT has a good protective effect on the intestine and spinal cord and can help to reduce the incidence of adverse events in patients.

Oncolytic viruses have made great breakthroughs in cancer treatment, especially for reovirus, which can effectively induce the death of tumor cells without harming the normal tissues. More than 80％ tumor cells are sensitive to reovirus infection. Reovirus induces the apoptosis of tumor cells and exerts anti-tumor immunity to achieve anti-tumor activity, and the curative effect of combination therapy with reovirus and chemotherapeutic drugs exceeds the effect of monotherapy. Reovirus can exert anti-tumor effects through different mechanisms, which is of great significance for the new and effective treatment of tumors in the future.