Objective To investigate the influence of self-management education(SME)on the selfmanagement ability and self-efficacy of patients with peripherally inserted central catheters(PICC).Methods Sixty patients with PICC were randomly divided into SME group(n=32)and control group(n=28).Patients in the SME group took SME and the control group received routine nursing;both lasted six months.The self-management ability(including self-management action,health status,catheter function,utility of health service)and selfefficacy were compared between these two groups.Results Except the scores of communication with the nurse (P=0.618),health status(P=0.083),and pain(P=0.069),the other indicators of self-management ability in the SME group had significantly higher scores than those in control group(all P<0.05).The incidence of complications was significantly lower(P=0.038)and the self-efficacy was significantly higher in SME group(P=0.012).Conclusion SME can improve the self-management ability and self-efficacy and prevent the catheter-related complications in patients with PICC.

[Objective]To observe the effects of chronic renal failure (CRF)on hearing and investigate its mechanism.[Methods] Twenty-nine male wistar rats were randomly divided into four groups:Ⅰthe normal rats as control for 12 days (n=6); Ⅱrats given adenine(ig) for 12 days (n=8); Ⅲthe normal rats as control for 24 days (n=6);Ⅳ rats given adenine(ig) for 24 days(n=9). The rat model of CRF was produced by being perfused of adenine [300mg/kg]for 12d and 24d. Brain-stem auditory evoked potential(BAEP) was utilized to evaluate the auditory function and renal tissue morphology was observed; Serum sampling was used to determine the content of Cr, BuN. The expression of NOSⅡin the cochlear was measured by immunohistochemical technique.[Results] After adenine given for 12d or 24d, the Cr and BuN were in significant higher level than that in control group. The BAEP thresholds were gradually higher than that in control group, the BAEP delitescence prolonged. Light microscopic observation of renal tissue showed that the degree of fibrosis was gradually higher. Data of immune histochemistry about the cochlear tissue showed that the expressions of NOSⅡ were feebly positive in the cochlear vassal texture, inner-outer hairy cell and helical-ganglion cell, and following functional damage of the kidney, their expressions reinforced gradually, amongst which strongest expression was vassal texture, the next helical-ganglion cell, the last inner-outer hairy cell.[Conclusion]CRF can result in deafness. It is likely concerned with toxic effects of the metabolizable substance, the metabolizable dysfunction of the electrolyte, shortage of trace elements, etc. One of the important mechanisms of the effects of CRF on hearing is the toxic damage of NO to cochlea.

Objective To study breathing characteristics of normal children of 6～7 years old when speaking in a normal manner.Methods RM 6240 physiological signal collection and processing system and Hx 100 respiratory transducer were used to collect the average peak expiratory pressure,inspiratory valley pressure,respiratory rate,respiratory depth from 160 normally speaking children.Results When speaking,the average peak expiratory pressure,inspiratory valley pressure,respiratory rate and respiratory depth of chest were all significantly increased (P<0.01);while that of abdomen was all reduced(P<0.05,P<0.01)except for respiratory rate(P<0.05)which was increased.In both respiratory conditions,all the data of abdomen were significantly larger than thaf of chest(P<0.01);all the data of boys were larger than that of girls(P<0.05,P<0.01).Conclusion When speaking,it involves thoraco-abdominal breathing,and the increase of chest activity will increase the volume of inhaled air.The increase of abdominal activity is for better control of respiratory airflow.Abdominal breathing plays a main role in normal speaking.Boys'respiratory muscles,respiratory organs are developed better than girls.

Reactivation of hepatitis B virus (HBV) in cancer patients with HBV infection during or after chemoradiotherapy can lead to acute liver injury,even death.Antiviral prophylaxis can reduce the occurrence of HBV reactivation and its associated morbidity.However,there is no unified standard to guide antiviral treatment.Therefore,multidisciplinary collaboration and more prospective study should be carried out to identify the individual antiviral treatment plan.

Objective To explore the factors related to effects and prognosis of surgical treatment of hilar cholangiocarcinoma.Methods The clinical data of 41 patients with hilar choIangiecarcinoma(HCCA) admitted in recent seven years were investigated and anlyzed retrospectively.Results Among 41 patients with HCCA,the accuracy rate of diagnosis by imaging technology was 95.1% before operation.Thirty-two cases were treated by surgical resection,of which 15 cases had radical resection and 17 cases had palliative resection,the total resection rate was 78.1%,and 9 cases had biliary internal drinage procedure.Two cases died during hospitilization.The rate of one-,three-and five-year survival for surgical resection was 70.0%,40.0% and 23.3% respectively,and for palliation drainage was 44.4%,11.1%,and 0%,respectively.The median survial time was 28 months and 8 months for surgical resction and palliation drainage,respectively.The difference between surgical resction and palliation drainage on survival rate and median survival time was signigicant(P

ObjectiveTo evaluate the effect of compound oxymatrine injection combination with chemotherapy in patients with advanced ovarian carcinoma.MethodsEighty-six patients with advanced ovarian carcinoma were divided by random digits table method into observation group(43 cases) receiving compound oxymatrine injection plus chemotherapy(paclitaxel plus carboplatin) and control group (43cases) treated with chemotherapy(p aclitaxel plus carboplatin) alone.The change of white blood cell,adverse reaction and effect of the patients were observed.ResultsThe white blood cell of observation group after treatment was obviously higher than that of control group [ (4.7 ± 1.4) × 109/L vs.(3.2 ± 1.6) × 109/L,P ＜ 0.05 ].The rates of nausea and vomiting,transaminase elevating and kidney damage of observation group were obviously lower than those of control group[ 16.3％ (7/43),14.0％ (6/43),20.9％ (9/43) vs.34.9％(15/43),32.6％ (14/43),44.2％ ( 19/43 ),P ＜ 0.05 ].The complete remission rate of observation group was significantly higher than that of control group[55.8％(24/43) vs.27.9％(12/43),P ＜ 0.05].Conclusion Addition of compound oxymatrine injection to chemotherapy for patients with advanced ovarian carcinoma can effectively protect patients against the decreasing of the white blood cell and attenuate the side effects brought by chemotherapy.

ObjectiveTo investigate the effect of humanized nursing in ovarian cancer patients to improve treatment compliance and negative emotional state. Methods120 cases of ovarian cancer patients from October 2009 to October 2010 in our hospital were chosen as the research object.They were divided into the control group and the observation group according to randomization methods with 60 cases in each group.The control group patients were taken routine care.The patients in the observation group were taken humanized nursing on the basis of routine care.The treatment compliances during treatment were compared.The anxiety,depression scores for the two groups of patients before and after treatment were compared.Based on the three indicators,the effect of humanized nursing in ovarian cancer patients to improve treatment compliance and negative emotional state was evaluated. ResultsThe treatment compliance during treatment for the two groups was compared,the full compliance of patients of the observation group was significantly higher than the control group.The difference between the two groups was statistically significant.The anxiety,depression scores before treatment for the two groups were compared.There was no significant difference between the two groups.The anxiety and depression scores showed significant improvement after the treatment,but improvement level of the observation group was significantly higher than the control group.The difference between the two groups was statistically significant. ConclusionsHumanized nursing can improve the treatment compliance and negative mood of ovarian cancer patients effectively,it is conducive to the rehabilitation of patients,and is worthy of clinical application.

We have conducted a tireless practice and exploration in order to establish a solid,long-term and appropriate social practice basement for medical students,which is the platform for them carrying on social practice activities.Practice has proved that early preparation for basement construction is the basis,support from local government is the key,leaders' attention 、abundant fund and multi-sectional coordination are the guarantee,and that diverse forms as well as effective social practice activities is the fundamental way to promote basement construction.

Pregnancy associated breast cancer (PABC) has many special characteristics,such as the clinical manifestation,pathology,diagnosis,treatment and prognosis.Due to the delay of diagnosis,the survival rate is low and the prognosis is poor.Early diagnosis and comprehensive individualized treatment with operation,radiotherapy and chemotherapy are needed to improve the prognosis of patients and prolong the survival period.

Objective Use McGurk effect paradigm materials to explore the role of lip-Reading for hearing-impaired children in phonetic identification.Methods Thirty-six severe prelingually hearing-impaired children and thirty-six normal healthy children(binaural PTA≤20 dB HL)were recruited in the study.The test material was composed of audio and video,including/ba/,/da/,/bi/,/di/,/bu/,/du/six stimulation sounds which were video recorded as pronounced.Under 3 different conditions,the two groups were evaluated for the accuracy of audi-tory responses.Results The accuracy of auditory responses of hearing-impaired children group was 0.71 ±0.19, 0.96±0.07,0.11 ±0.16 for auditory-only mode,audio -visual consistent mode and audio -visual inconsistent mode,respectively,0.93±0.10,0.96±0.11,0.54±0.23 for normal hearing children in auditory-only mode,audi-o-visual consistent mode and audio-visual inconsistent mode,respectively.Conclusion The Audio-visual con-sistent mode is the best one and the lip-reading can help hearing-impaired children in phonetic identification.