This paper analyzes ethical issues to be concerned in the nursing process for patients' with severe degree burn,and comes up with countermeasures including building up comfortable environment of medical service,showing enough respect for patients,improving mutual communication between doctors and patients,applying flexible regulations of visiting and accompany,strengthening health propaganda,and making best efforts to maintain the original appearance and function of the burnt organs.

Since the first reported case of swine influenza A in Mexico,a total of 15 510 cases have been confirmed in 53 countries by May 29,2009.On April 29,2009,the World Health Organization(WHO)raised its pandemic alert from grade 4 to grade 5.The virus is described as a new subtype of A/H1N1 and is not detected in pigs or humans previously.The virus is sensitive to oseltamivir and zanamivir,but resistant to amantadine and rimantadine.The genetics of the virus are so novel that humans are unlikely to have much immunity to it.The virus can transmit from human to human;therefore it is necessary to enforce quarantine measure for close contactors because the virus transmits during latency.Precaution methods like covering noses and mouths with a tissue when coughing or sneezing can reduce the transmission opportunity.Hands should be washed frequently with soap,especially after coughing or sneezing.Public places with ventilation conditions,personal health behavior and health condition are critical for the prevention and control of this epidemic.

Office blood pressure has been regarded as a gold standard of blood pressure measurements.It is an important indicator of ensurement of correct diagnosis,management of condition and evaluation of prognosis.But limitations of office blood pressure have led to the increasing use of out-of-office blood pressure.Many evidence show that out-of-office blood pressure could more accurately reflex variability of blood pressure and rhythm of blood pressure.Out-of-office blood pressure could diagnose white-coat hypertensives or masked hypertensives without delay,properly determine the need for antihypertensive treatment and decrease risk of developing blood pressure-related complications.

Objective: To study the relationship between different patterns of invasion and extracapsular spread in lymph node metastasis from squamous cell carcinoma of tongue. Methods: Pattern of invasion described by Anneroth was used to evaluate the malignance grade of tongue cancer and immunohistochemical and HE staining were used to detect the extracapsular spread in successive cases of tongue cancer with radical neck dissection. Results: Lymph node metastasis was observed in 0/5 of the cases with pattern I invasion,3/8 pattern II,5/6 pattern III and 1/1 pattern Ⅳ. Extracapsular spread occurred as totally or partly replacement of the lymph node by the tumourcells. The tumour cells infiltrated between lymph nodes, perinodal fibroadipose tissue or sternocleidmastoid muscle in the form of cell cluster or isolated cell. Conclusion: Pattern of invasion is a significant factor for evaluating the malignance grading of tongue cancer. Radical neck dissection should be used to treat the tongue cancer with pattern III or IV invasion.

This paper presents a description about training of post-graduate students majoring in rheumatology.The essential knowledge and theory are highly stressed,and the clinical skill,comprehensive ability are also emphasized to encouraging students to bring forth new ideas.Besides cooperation and team spirit are encouraged through group and pair work.

From the perspectives of social equitable exchange theory, contents and features of exchange between medical staff and patients in the doctor-patient relationship as well as their evalua-tion on social equitable exchange theory were analyzed according to basic features of doctor-patient relationship. Suggestions were proposed from government, industry, hospital and medical staff.

Objective To analyze the clinical effects of small needle -knife therapy with movement exercise on knee osteoarthritis (KOA).Methods The clinical data collected from all the patients with hospital care and other 60 patients with KOA treated in the outpatient department in People's Hospital of Changzhi from February 201 4 to August 201 4.The patients were divided into needle -knife group and hyaluronan group,30cases in each group.The needle -knife group was given small needle -knife therapy to each patient one or two times.The hyaluronan group was given weekly intra -articular hyaluronan treatment,once a week,5times in total.But all the patients must do the same exercise movement as treatment.The clinical efficacy evaluation went on 6 months to follow up the patients.The evaluation for each patient was made at 0.5,1 st,2nd,4th,and 6th months using the following measures:WOMAC (Western Ontario and McMaster University Osteoarthritis Index)global assessment and SF -36 (short form 36). Make a contrast to the efficacy of both therapies on the osteoarthritis of knee joint from pain -easing and functional recovery.And the results were synthetically analyzed.Results In terms of pain assessment,the outcomes obtained by WOMAC on the two groups was statistically effective in the phase of 1 -6 months (t =-5.952,P <0.001 ),while those by SF -36 showed differences between the first 0.5 month and 6th month (t =3.1 21 ,P <0.001 ,t =4.091 , P =0.01 1 ).In terms of the functional assessment,the figures obtained by the WOMAC manifested that the needle -knife group was significantly superior to the hyaluronan group at the second and sixth months (t =-8.579,P <0.001 ,t =-3.993,P =0.003),and SF -36 also displayed that after treatment,the objects from the two groups per-formed distinctively in the first half,first,and sixth month respectively.(t =6.1 32,P <0.001 ,t =5.063,P =0.0068, t =8.1 09,P =0.003).Conclusion Small needle knife with movement exercise can obviously improve activity -related function of knee joint and relief the pain for the patients with KOA.

Objective To investigate the specific activity of 24Na per unit neutron fluence,AB/Φ,in blood produced for Chinese reference man irratiaded by 252Cf neutron source,and to analyze the effects of scattering neutrons from ground,wall,and ceiling in irradiation site on it.MethodsA 252Cf neutron source of 3 × 108 n/s and the anthropomorphic phantom were used for experiments.The phantom was made from 4 mm thick of outer covering by perspex and the liquid tissue-equivalent substitute in it.The data of phantom dimensions fit into Chinese reference man.The weight ratios of H,N,O and C in substitute equal from source to long axis of phantom were 1.1,2.1,3.1 and 4.1 m,respectively.Both the neutron source and the position of xiphisternum of the phantom were 1.6 m above the floor.ResultsThe average specific activity of 24Na per unit neutron fluence was related to the irradiation-distances,d,and its The AB/ΦM corresponds to that of phantom irradiated by plane-parallel beams,and the value is about more 3% than that by BOMAB phantom reported in literature.It has shown that floor-( wall-)scattered neutrons in irradiation site have significant contribution to the specific activity of 24Na ,but they contributed relatively little to the induced neutron doses.Consequently,using the specific activity of 24 Na for assessing accidental neutron doses received by an individual,the contribution of scattered neutrons in accident site will lead dose to be overestimated,and need to be correct.

ObjectiveTo explore the relationship between the expression of Dishevelled2 and Vangl2 and the embryonic neural tube defects (NTDs) induced by all-trans retinoic acid (RA)in Kunming mouse. Methods Fifty pregnant mice were randomly divided into control and RA-treated groups.RA-treated mice were fed with 30mg/kg RA dissolved with peanut oil on embryo 7.75 days, while the mice of control group were administrated with an equal volume of peanut oil on the same time. Then all the embryos were sampled from pregnant mice at the 4th, 18th, 42nd, 66th and 90th hour after treatment. In situ hybridization and immunohistochemical staining technique were used to detect the expression of Dishevelled2 and Vangl2 in embryonic neural tube. Results The two proteins both existed in the epithelial tissue of the mouse embryonic neural tube and displayed different expression modes at various developmental stages.Compared with the control group, the RA treated group showed a significant decrease (P≤0.05) at the 18th and 42nd hour and a significant increase (P≤0.05) at the 66th hour in Dishevelled2 protein after maternal treatment, and no significant difference was found at the 90th hour. Compared with the control group, the Vangl2 mRNA expression in the RA treated group displayed a significant decrease (P≤0.05) at the 4th and 18th hour and a significant increase (P≤0.05) at the 66th hour after RA treatment, and no difference was found at the 42nd hour. Compared with the control group, the expression of Vangl2 protein in the RA treated group decreased (P≤0.05) at the 18th and 42nd hour, and increased (P≤0.05) at the 90th hour after RA treatment, no difference was found at the 66th hour. Conclusion Excessive RA may interfere with the normal embryonic neural tube closure by regulating the expression of Dishevelled2 and Vangl2.