Objective To observe the clinical effect of Xiaoaiping Injection combined with gemcitabine and carboplatin in the treatment ofⅢB and Ⅳ non-small cell lung cancer (NSCLC).Methods Totally 106 NSCLC patients from Huangshi Central Hospital of Edong Medical Group were sellected in this study.The patients were divided into gemcitabine and carboplatin control group (n =53)and Xiaoaiping Injection combined with gemcitabine and carboplatin observation group (n =53).The clinical efficacy and adverse reactions were compared between two groups.Results After four cycles of treatment,the effective rate and control rate in observation group were 39.6％ and 77.4％,and those in control group were 35.8％ and 75.5％.There was no significant difference between the two groups.The decline rates of white blood cells,hemoglobin,and platelet in observation group were 41.5％,37.7％,and 45.3％,which were significantly lower than those of 64.2％,62.3％,and 69.8％ in control group (P ＜ 0.05).There was no significant difference of renal function injury,liver function damage,nausea,vomiting,dizziness,headache,diarrhea,and constipation between two groups.In observation group,the median survival time was 8.4 months,time to tumor progression was 5.3 months,and 1 year survival rate was 26.4％.In control group,the median survival time was 7.7 months,time to tumor progression was 4.2 months,and 1 year survival rate was 11.3％.There was significant difference between two groups (P ＜ 0.05).Conclusion Xiaoaiping Injection combined with gemcitabine and carboplatin can reduce the hematologic toxicity of chemotherapy drug in the treatment of ⅢB and Ⅳ NSCLC,and improve long-term clinical outcomes.combined with gemcitabine and carboplatin can reduce the hematologic toxicity of chemotherapy drug in the treatment ofⅢB and Ⅳ NSCLC,and improve long-term clinical outcomes.

[Objective]To investigate the causes and treatment methods of postoperative complications of femoral fractures treated with interlocking intramedullary nails.[Method]A total of 243 cases of femoral fractures from Jan 1999 to Dec 2004 were treated with interlocking intramedullary nails.There were 14 cases having complications,delayed union in 1,nonunion in 3,nailing failure in 6(locking scerw loosen in 4,locking scerw folding in 1,locking scerw breakage in 2),nail breakage in 1,re-fracture in 1 and knee ankylosis in 1.Two cases with delayed union to convert the fixation from statictody namicin time;3 cases with nonunion were treated with bone grafting.Breakage nail and re-fractuer cases were treated with enlarging intramedullary tunels,exchanging nails and bone grafting.One of locking scerw loosen were treated with exchanging nails and bone grafting.Knee ankylosis were treated with quadriceps plasty.[Result]Through treatment,the delayed union and the nonunion were all healed and got recovery of knee function.[Conclusion]Though it has certain complications,the interlocking intramedullary nails used for femoral fractures have more advantages than other internal fixations.It needs to take valid measures to reach a satisfying result when complication appears.

Objective To study surgical treatment of complex fractures of the tibial plateau. Methods Forty eight cases of complex fractures of the tibial plateau were treated with internal fixation from January 1997 to December 2001. According to Schatzker classification, 12 cases were type Ⅲ, 9 cases type Ⅳ, 14 cases type Ⅴand 13 cases type Ⅵ. They were treated with open reduction and internal fixation with buttress plates and allograft implantation for defective fractures. Results Forty six cases of the forty eight were followed up for 1 to 4 years. The excellent and good rate was 77%. Conclusion The complex fractures of the tibia plateau should be treated surgically, and the operation procedures should be varied according to the fracture types.

Objective To explore the comprehensive nursing intervention on coping style and self -efficacy in chronic hepatitis B patients .Methods Eighty chronic hepatitis B patients were chosen and randomly divided into the control group and the observation group , each with 40 cases.The control group received the routine nursing , and the observation group received the nursing intervention on the basis of routine nursing .The coping style and self-efficacy were compared through the Medical Coping Modes Questionnaire ( MCMQ ) and General Self-efficacy Scale (GSES) between two groups after 3 weeks.Results The subscale scores of MCMQ including face, avoid and abandon were respectively (27.93 ±5.84), (10.91 ±5.90), (4.94 ±1.09) in the observation group after the intervention , and were better than those of the control group , and the differences were statistically significant (t=4.65,2.24,9.73, respectively;P<0.05).The differences were found in the scores of face, avoid and abandon in the observation group before and after the intervention ( P <0.01 ).The differences were found in the scores of avoid and abandon in the control group before and after the intervention (P<0.05).The total scores of GSES was (20.50 ±5.50) in the control group after the intervention , and was lower than (30.35 ±5.0) in the observation group, and the difference was statistically significant (t=8.38, P<0.05).Conclusions Nursing intervention can change the coping style and improve their self-efficacy in chronic hepatitis B patients .