Through the investigation on medical students' understanding of hospice care and their cognition and attitudes on voluntary services in hospices in Wenzhou,this paperconcluded that medical students accepted hospice care highly but knew little about it,and medical students were willing to participate in hospice care but actually rarely attended it.It is also suggested that universities should strengthen the propaganda and education of hospice care and volunteer service,joint efforts should also be given to expand the service opportunities and channels,and trainings should be provided to improve the development of hospice care volunteer services among medical students.

Objective To investigate the clinical efficacy of warm needling plus palm pressing spine reduction technique in treating postpartum thoracic facet joint disorder.Methods Forty patients with postpartum thoracic facet joint disorder were randomly allocated to treatment and control groups, 20 cases each. The treatment group received warm needling plus palm pressing spine reduction technique and the control group, warm needling alone. The numeric pain rating scale (NPRS) score, the Oswestry Disability Index (ODI) score and the Quality of Life Scale score were recorded in the two groups before and after treatment and the clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 95.0% in the treatment group and 75.0% in the control group; there was a statistically significant difference between the two groups (P<0.01). There were statistically significant pre-/post-treatment differences in the NPRS score and the ODI score in the treatment group (P<0.01). There was a statistically significant pre-/post-treatment difference in the NPRS score in the control group (P<0.01). There were statistically significant post-treatment differences in the NPRS score and the ODI score between the treatment and control groups (P<0.01,P<0.05). There were statistically significant pre-/post-treatment differences in the SF-36 PF, RP, BP, VT, SF and MH scores in the treatment group (P<0.01,P<0.05). There were statistically significant pre-/post-treatment differences in the SF-36 PF BP, SF and MH scores in the control group (P<0.01,P<0.05).Conclusion Warm needling plus palm pressing spine reduction technique is an effective way to treat postpartum thoracic facet joint disorder.

Objective To evaluate the efficacy and side-effects of the levonorgestrel-releasing intrauterine device (Mirena) in the treatment of dysfunctional uterine bleeding .Methods 45 cases of dysfunctional uterine bleeding diagnosed by pathology were installed with Mirena.The endometrial thickness by ultrasound hemoglobulin increase and pathologic changes of endometria were recorded before and 24 months after the installation.ResultsThe endometrial thickness before and after the insertion of Mirena were(15.6 ±4.2) mm and (3.2 ± 1.3)mmrespectively (P ＜ 0.01) .Six months after the insertion of Mirena, patients' hemoglobulin was significantly increased from (97.6 ± 8.2)g/L to (123.7 ± 8.1)g/L (U = 2.26, P ＜ 0.05) .After the installation of Mirena, patient experienced metrorrhagia.Conclusions Mirena is a device providing effective and continual therapy for dysfunctional uterine bleeding .It can not only significantly reduce the menstrual blood loss but also reverse the complex hyperplasia effectively.

The original meaning of Portfolio is briefcase, generally translated as study archives in our country, with learners as the center, through the process of goal setting, feedback learning, self-reflection, steps, to show yourself and target revision form of process evaluation with learners as the center, to continuously promote the personal comprehensive ability through reflective learning progress. Portfolio, introduced in clinical admissions bilingual teaching, through six aspects such as individual learning, classroom display, clinical teaching, practice process and result display and target changes, and through the learning process assessment (fuzzy comprehensive evaluation method) and professional knowledge assessment (mini) method evaluating the clinical practice, evaluates Portfolio, in order to improve the medical students' clinical thinking and their comprehensive ability of lifelong learning,and promote the medical students' all-round development.

Objective To observe the clinical efficacy of the early activity on preventing deep vein thrombosis after joint replacement. Methods A total of 90 patients who undergone skeleton and knee joint replacement from January 2014 to January 2015 were randomly divid-ed into the observation group and the control group (with 45 cases in each group)according to the random number table method.The control group were given routine nursing care to prevent thrombosis,while the observation group were given intervention nursing,namely implementa-tion of early activities.The related symptoms of deep venous thrombosis and D-dimer level of high blood coagulation state of plasma of the two groups were observed and compared before and after treatment.Results The symptoms of deep vein thrombosis of the observation group in the early postoperative period were less than that of the control group,and the difference was significant(P <0.05).The D-dimer level of the observation group was lower than that of the control group 7 days after the operation with a significant difference (P <0.05).Conclusion Systematic nursing intervention of early activities can significantly reduce the related symptoms of forming deep vein thrombosis after joint re-placement.In addition,it has an apparent effect on lowing the high blood coagulation state and preventing deep vein thrombosis.

Objective To determine the content of polysaccharide of prepared pinellia tuber. Methods The content was determined by sulfuric acid-anthrone colorimetric method with wavelength at (624?1)nm. Results The content of polysaccharide was 2.533 mg/g in prepared pinellia tuber. The average recovery was 99.54% and RSD was 1.69%. Conclusion The methods was simple, steady and reproducible.

Objectives To explore the effects and mechanism of acupuncture treatment in emergent of acute hypertension by studying the acupuncture treatment on acute hypertension rats. Method The acute hypertension rat model was made by injecting adrenalin into the abdomen. After probing specific points, NO, ET-1, angiotensin and rennin levels were tested. Results Acupunctured for 30 minutes, the experimental group's diastolic pressure dropped and NO level rose, and these changes were statistically significant regarding those of the medicine control group. After the acupuncture treatment, the rennin level of the medicine control group and the experimental group were statistically different with the control group, but no significant difference was found between the medicine control group and the experimental group. Conclusion Probing Quechi, Taichong, Sanyinjiao and Neiguan may lead to the improved performance of the vessel endoderm, the rise of NO level and the decrease of angiotensin content, and consequently reduce the blood pressure of acute hypertension rats.

Objective: To study validity and reliability of Wolf motor function test (WMFT) on assessing the upper extremities motor function of acute stroke patients so as to guide clinical application. Method: Twenty-three stroke patients in acute stage participated in the study. Patients were assessed twice with WMFT and the upper extremities motor function test of Fugl-Meyer movement assessment (U-FMA) within one week. The correlation between the assessment results of WMFT and U-FMA were analyzed to study the validity and reliability of WMFT. Result: WMFT was highly correlated with U-FMA in total scores (r =0.922, 0.929, P＜0.001). There were high correlation in all items of WMFT between two assessment sessions. The intraclass correlation coefficients (ICC) were 0.989, 0.997 for intrarater and 0.980, 0.991 for interrater. Conclusion: The WMFT is valid and reliable on assessing upper extremities motor function of stroke patients in acute stage.

Aim To investigate the role of GDF11 in palmitate induced skeletal muscle insulin resistance.Methods The C2C12 cells were sorted into control group, GDF11 intervention group, palmitate group and GDF11 combined with palmitate group.Cell viability was measured by CCK-8, and the glucose uptake was determined by 2NBDG.The mRNA level of myotube marker genes(desmin,myogenin), insulin mediate glucose uptake related genes(GLUT-4,IRS-1) and PGC-1α were tested by RT-PCR.The protein expression of PGC-1α was detected by western blot.Results GDF11 had little effect on cell viability of skeletal muscle cells.Compared with control group, the glucose uptake and the expression of GLUT-4,IRS-1,PGC-1α were significantly decreased by palmitate intervention.Compared with palmitate group, the glucose uptake and the expression of GLUT-4,IRS-1,PGC-1α were not significantly changed by GDF11.Conclusion Palmitate can induce skeletal muscle cell insulin resistance, but GDF11 may not significantly improve the skeletal muscle cell insulin resistance.

Objective To explore clinical efficacy of local random flap in reconstruction of facial skin and softtissue defects caused by lesions resection and injury.Methods Forty-six cases with facial skin and soft-tissue defects were cured by constructing and transplanting different local random flap that is designed according to parts,shapes and sizes of defect between July of 2008 and June of 2013.Results All the cases obtained satisfactory effects for full survivorship of flap,one-stage healing of wound,tiny scar and pigmentation,and good appearance by following up from 3 months to 6 months after operation.Conclusions Using local random flap in repair of facial skin defect could get satisfactoried functional and aesthetic efficacy,and it is worth being applicatied in the clinic.