Object:To describe Chinese systemic family therapy process through analysis on the therapeutic experience of 4 Chinese systemic family therapists.Method:Four well-certificated systemic family therapists in China were selected as research sample.A semi-structure interview under the guidance of a self-compiled interview outline was made with every therapist.Transferred raw data was analyzed with deductive thematic analysis following 5 steps:coding,themes searching,themes reviewing,themes defining and naming,themes merging and revision.Results:(1)Respectively 102,93,97,and 95 codes were got from each piece of interview raw data,which generated 57,52,50,and 33 primary themes.Five main themes emerged from the merging of the primary themes.(2)Themes and sub-themes constructed the theoretical hypothesis on the change process of Chinese systemic family therapy.Conclusion:There is an experiential manipulating model in Chinese systemic family therapy process under the guidance of systemic therapeutic philosophy,which is integrated with some therapeutic technique from other psychotherapy models.This model can be studied with deductive thematic analysis.

Stethoscope diaphragms were sampled randomly for bacteria culture and identification from nursing and medical staff in 3 community health institutions in Zhongshan city. Anonymous filling in questionnaire was taken for investigating frequency of cleaning stethoscope by staff. A total of 100 stethoscope diaphragms were sampled, and a total of 523 bacteria strains were isolated. Eighty-six percent of stethoscopes surveyed were contaminated with bacteria, among the isolated organisms, G+ bacteria and G-bacteria accounted for 78% and 22% respectively. The Bacterial contamination rate and G- rate of stethoscopes used by inpatient staff were 6. 2 strains and 2. 1 strains per stethoscope respectively, which were significantly higher than those used by outpatient staff (4. 8 strain and 1. 1 strain per stethoscope, P ＜0. 05 and P < 0. 01, respectively). A total of 105 questionnaires showed that 21% (6/28) of nursing staff cleaned stethoscope monthly, meanwhile 12% (7/56) of outpatient medical staff and 14% (3/21) of inpatient medical staff (P ＜0. 01) did so; 29% (8/28) of nursing staff cleaned their stethoscopes once a year or never, meanwhile, the figures for outpatient and inpatient medical staff were 55% (31/56) and 57% (12/21) respectively (P ＜0. 01). Results indicate that there is high rate of bacterial contamination in stethoscopes, and G- is more frequently found in stethoscopes used by inpatient staff than outpatient. In general, the frequency of stethoscope cleaning is low, however, more frequently for nursing staff than medical staff.

Objective To investigate the relationship among Survivin, PTEN and the occurrence, development, soakage and prog-nesis of gastric cancer. Methods The in-situ hybrization technique, immunochemistry and TUNEL method were used to detect the expres-sion of survivin mRNA, PTEN protein and apoptotic cell. Results The positive rate of survivin expression in gastric cancer was obvious higher than that in para-cancer tissue(P <0.01). Moreover, survivin expression rate in advanced clinical stage and low differentiation gastric cancer degree.was higher, compared with para-cancer tissue (P <0.01, P <0.05). The positive rate of PTEN expression in gas-tric cancer was obvious lower than that in pars-cancer tissue (P <0.01). The positive rate of PTEN expression in advanced clinical stage and low differentiation degree of tissue in gastric cancer was lower (P < 0.01). Furthermore, survivin and apoptesis indexes manifested negative relationship in gastric cancer(r =-0.861, P < 0.01), While PTEN and apoptosis indexes manifested positive relationship (r = 0.832, P < 0.01). Conclusions Survivin could be used as a novel marker to detect gastric cancer. PTEN gene lost function, which maybe promote the origin, growth, soakage and metastasis of gastric cancer.

Objective To investigate the function of TRAIUCaspase-3 and NF-κB among the occurrence, development and malignant invasion of bile duct carcinoma. Methods The in-situ hybrization technique and immunochemistry method were adopted to detect expression of TRAIL, Caspase-3 and NF-κB. Results The positive rates of TRAIL expression in carcinoma of bile duct and paracancer tissue were 45.2 % (19/42) and 53.3 %(8/15), respectively. The differences were not significant (P >0.05), and there were no evident difference between expression of TRAIL and every clinic pathology factor(P >0.05). The positive rates of Caspase-3 expression in carcinoma of bile duct were 30.9 %(13/42), which were obviously lower than those in paracancer tissue, 60.0 %(9/15)(P<0.05). However, The positive rates of NF-κB expression in carcinoma of bile duct were 61.9 %(26/42), obviously higher than those in paracancer tissue, 26.7 %(4/15)(P <0.05). The positive rates of Caspase-3, NF-κB expression were relation to metastasis and proliferation, differentiation degree of tissue and survival time (P <0.05), but were independent of sex, ages and position of carcinoma(P > 0.05). Moreover, TRAIL and Caspase-3 manifested positive relationship (P <0.05). On the contrary , NF-κB and Caspase-3 manifested negative relationship (P <0.05). However, there was no relationship between TRAIL and NF-κB(P >0.05). Conclusion Expression of TRAIL has no selectivity of tumour, Its expression is higher or lower which couldn' t absolutely decide tumour' s metastasis and proliferation, and could not decide malignant degree and prognosis of tumour, too. Activation of NF-κB and losing action or absence of Caspase-3 possibly accelerate metastasis and proliferation of tumour, which result in bad prognosis. NF-κB interdicte TRAIL inducing apoptosis approach via control activation of NF-κB, which induce tissue to avoiding apoptosis and multiplication unboundedly, leading to tumour's occurrence, development, metastasis and diffuseness.

Objective To discuss the application of Chaperon guiding catheter system in endovascular treatment of intracranial aneurysms. Methods A total of 20 patients with intracranial aneurysms were enrolled in this study. The patients hadⅡorⅢtype of aortic arch (n=11) or sclerotic plague at the orifice of internal carotid or vertebral artery (n = 9). Endovascular embolization of the intracranial aneurysm was carried out in all patients. By using Cordis guiding catheter system the catheter was placed into the target artery. Chaperon guiding catheter system was used during the procedure in order to determine whether the Chaperon guiding catheter could be smoothly placed into the target artery or not. Results When the Chaperon guiding catheter system was employed in the endovascular procedure, the difficulties of catheterization caused by the distortion of the aorta or by the plagues on the walls of arteries could be basically overcome. The Guiding catheter could be smoothly placed into the target arteries. Conclusion The Chaperon guiding catheter system can be successfully used in the endovascular treatment for the intracranial aneurysms, especially when the patient has tortuous aorta or there is sclerotic plague on the artery wall. (J Intervent Radiol, 2014, 23:281-283).

Objective To observe the effect of electromyographic biofeedback therapy(EMGBFT)on dysphagia in stroke patients.Methods Fifty-three stroke patients with dysphagia were divided randomly into an EMGBFT group and a control group.The patients of EMGBFT group were given EMGBFT,electrical stimulation therapy (EST)and dysphagia training,while those in the control group were given EST and dysphagia training.All the patients were assessed with Kubota drinking test before treatment and 30 days after treatment.Results After treatment swallowing function of patients in both groups improved(P ＜0.05).The effective rate was 76.92％ in EMGBFT group and 55.56％ in control group,with statistically significant difference between the two groups(P ＜ 0.05).It showed that the EMGBFT group has significantly better outcome than the control group after treatment(P ＜ 0.05).Conclusions EMGBFT combined with regular rehabilitation therapy can improve patient's motor and swallowing function.

OBJECTIVE:To standardize periooperative prophylactic application of antibiotics. METHODS:According to the characteristics of orthopaedic and parenchyma surgery,classifying evaluation table of typeⅠincision infection risk was designed sci-entifically and rationally. The individual application of antibiotics in surgery patients had been achieved through infection risk evalua-tion. High risk typeⅠincision patients used antibiotics rationally and low risk patients seldom used or didn’t use at all. RESULTS:Through using infection risks classifying table,the rate of antibiotics prophylactic application in typeⅠincision drops from 74.10%to 28.68%,and and the per capita duration of antibiotics prophylactic application shortened from 4.23 d to 2.21 d. The postopera-tive infection rate remained the same. CONCLUSIONS:Through infection risk classifying evaluation,individual application of anti-biotics can be achieved in surgery patients,so as to promote rational use of antibiotics for prophylactic use,reduce antibiotics dos-age and antibiotics abuse under the condition of controllable surgery infection.

Objective:To research and compare the therapeutic effect of oxycodone hydrochloride controlled—release tablets and morphine sulfate controlled—release tablets on the visceral cancer pain.Methods:Total of 72 patients with visceral cancer pain were randomly assigned into two groups:OO group was treaded by oxycodone hydrochloride controlled—release tablets,MO Group was given morphine sulfate controlled—release tablets.According to the principle of NCCN(2008),the two groups were titrated by morphine,and then diverted to controlled-release agent.The visual analogue scale(VAS)was kept smaller than 4.The side effects of two groups'and the rescue analgesic doses were recorded after the application of the controlled-release agent for 15 days,and the cost-effectiveness was analysed.Results:The rescue analgesic doses of the OO group were smaller than that of the MO group (P0.05).Conclusion:The two drugs have notable analgesic effect in the visceral cancer pain.Considered gastrointestinal tract side effects and the rescue analgesic dose,Oxycodone hydrochloride controlled—release tablets surpass the Morphine sulfate controlled-release tablets.Oxycodone hydrochloride controlled-release tablets may be a potential regimen for visceral cancer pain.

Objective To study the correlation of peritumor brain edema and the proliferation of meningiomas.Methods Forty-six patients who underwent resection of meningioma were divided into four groups(no,mild,middle and severe PTBE) according to CT.Proliferating cell nuclear antigen(PCNA) was detected with immunohistochemistry.Results There were 18 cases mild PTBE[PCNA LI (2.83?1.57)],10 cases middle PTBE[PCNA LI (3.14?2.04)] and 5 cases severe PTBE[PCNA LI (4.13?2.43)] in forty-six patients.PTBE was related to meningioma PCNA LI significant.Conclusion PTBE of meningioma relates with tumor cell proliferation.

Objective To report the clinical outcomes of the patients with open comminuted intra-articular calcaneal fracture who were treated with our self-designed bilateral triangle external fixators which are extensible and gimbaled.Methods Between January 2011 and June 2014,12 patients with open comminuted intra-articular calcaneal fracture were treated and followed up.They were 8 men and 4 women,aged from 23 to 58 years (average,36.8 years).According to the Sanders classification,the fractures were type Ⅱ in 4 cases,type Ⅲ in 7,and type Ⅳ in one.According to the Gustilo classification,the soft tissue injury was type Ⅱ in 2 cases,type ⅢA in 7,and type Ⅲ B in 3.All the patients were treated with immediate debridement and preventive intravenous antibiotics.First stage wound closure or temporary coverage with vacuum sealed drainage was chosen according to the condition of soft tissue injury.Our self-designed bilateral triangle external fixators were applied together with cannulated screws or Kirschner wire in all the patients after Kirschner wire poking.Of them,7 received emergency treatment and 5 were treated 3 to 5 days after injury.After no wound infection was observed for sure,6 cases received selective open reduction and internal fixation via a lateral incision while 6 continued external fixation with Kirschner wire for 8 to 10 weeks (average,9.1 weeks).Results The 12 patients were followed up for 6 to 36 months (average,18.5 months).Their AOFAS scores averaged 84.6 points (range,from 74 to 94 points).One case required tissue transfer for wound coverage.Wound shallow infection developed in 3 cases.No deep infection or amputation happened.No wound infection or necrosis occurred in the 6 cases that had undergone open reduction and internal fixation at the second stage.Conclusion Application of our self-designed extensible gimbaled bilateral triangle external fixators in the treatment of open comminuted intra-articular calcaneal fractures may help effectively reduce the deep infection or incidence of osteomyelitis after operation as long as early debridement is thorough,internal fixation is timely applied,and indications for internal fixation are properly followed.