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.

Objective To analyse the factors influencing the death of patients with aortic dissection (Stanford type A arota dissection) who underwent urgent surgery.Methods The clinical data of 197 patients with aortic dissection (Stanford type A arota dissection) treated with urgent surgery from the First Affiliate Hosiptal of Xinjiang Medical University were retrospectively analyzed between January 2009 and June 2015 in order to determine the factors influencing the early-mortality.Results Of them,23 patietns dead.In univariant analysis,the rate of mortality was 11.68％.The following factors at admission were independetly associated with early-mortality:hypertension,coronary atherosclerotic heart disease,LVEF ≤ 50％,time consumed for CPB ≥ 180 min,time required for cross-clamping aorta ≥ 120 min,Cr ≥ 130 μmol/L,rethoracotomy for hemostasis (P ＜0.05).The preoperative renal failure (Cr≥130 μmol/L) and time consumed for cross-clamping aorta ≥ 120 min were strongly associated with the early-mortality based on the logistic regression analyses.Conclusions The risk of aortic dissection surgery is very high,and it is mondatory to carefully evaluate the patient' s general condition and the indications during peroperative period,and to take active measures to shorten the time of clamping aorta and total operation time in order to reduce the risk of operation and increase the survival rate of patients.

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 evaluate the relationship between the existence of DME and the SFCT in DR pa-tients. Methods We collected 70 cases which were clinical diabetic involving 122 eyes. They are 36 men with 64 eyes and 34 women with 58 eyes. The average age is 56.7 ± 9.7 year-old. All patients had been examined by oph-thalmologic examination. Grouping: patients without diabetic retinopathy (NDR) group; mild-to-moderate NPDR group; severe NPDR group; PDR group. The last three groups were divided into two subgroup groupsrespectively , which were cases with and without significant macular edema (CSME + / CSME). EDI was used to measure the SFCT. SPSS 17.0 software was used for statistical analysis. Results The average SFCT of NDR group, mild-to-moderate NPDR group, severe NPDR group and the PDR group respectively were (282.94 ± 104.21)μm, (313.62 ± 94.40)μm, (382.44 ± 76.91)μm, (335.00 ± 73.82)μm. Compared with the NDR group, SFCT was thicker than the other three groups, and difference was statistically significant (F = 2.786, P = 2.786). There were no statisti-cally significant difference of SFCT between the mild-to-moderate NPDR/CSME - group and mild-to-moderate NPDR/CSME + group, severe NPDR/CSME - group and severe NPDR/CSME + group PDR/CSME-group, PDR/CSME + group. Conclusions The SFCT of DR patients could potentially be thickenedas disease became serious. When considered the same degree DR, there is no obvious difference of SFCT between patients with CSME and without CSME.

Objective To observe the clinical efficacy of auricular acupuncture plus acupoint injection at Zusanli (ST 36) in treating shoulder pain due to gynecologic laparoscopy.Method Totally 120 patients with shoulder pain due to gynecologic laparoscopy were randomized into a treatment group and a control group, 60 cases in each group. The treatment group was intervened by auricular acupuncture plus acupoint injection at Zusanli (ST 36), while the control group was by ordinary analgesics. The clinical efficacies were compared after 2 treatment courses.Result The Visual Analogue Scale (VAS) scores, Present Pain Intensity (PPI), and the item scores of the Short-Form (36) Health Survey (SF-36) were significantly changed in both groups after treatment (P<0.01,P<0.05). There were no significant differences in comparing the VAS score, PPI, and the item scores of SF-36 between the two groups (P>0.05). The total effective rate was 95.0% in the treatment group versus 75.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Auricular acupuncture plus acupoint injection at Zusanli (ST 36) is effective in treating shoulder pain due to gynecologic laparoscopy, and it can effectively reduce the occurrence of complications.

BACKGROUND: Studies have confirmed that nerve growth factor can promote wound tissue to release al kinds of endogenous growth factors and growth factor receptors, which play a positive regulatory role. The nerve growth factor can promote cel proliferation and accelerate wound healing, thus making the wound healing developed from the passive waiting healing to active control healing. OBJECTIVE: To investigate the effects of local application of nerve growth factor on the expressions of transforming growth factor β1 and basic fibroblast growth factor in rat burn wounds. METHODS: Twenty-four adult Sprague Dawley rats were used in the study, and Ⅱ degree deep burn wound was made on the back of rats. Then, these rats were randomly divided into four groups. After burn wound debridement, the wounds were covered with gauzes containing 1, 2.5 and 5 μg/mL nerve growth factor solution and normal saline respectively. At 3, 5, 9 and 14 days after treatment, the wound healing time and percentage of residual wound were observed. Then, wound tissues were cut for histological examination, in order to detect the expressions of transforming growth factor β1 and basic fibroblast growth factor in wounds, as wel as the cel ular DNA cycle. RESULTS AND CONCLUSION: The wound healing time in the treatment groups was shorter than that in the control group, especial y in 5 ug/mL nerve growth factor treatment group (P < 0.01), and the percentage of residual wound in the treatment groups was less than that in the control group. The histological examination showed the number of nucleated cells in the superficial dermis of the treatment groups was significant increased when compared with that in the control group; the expressions of transforming growth factor β1 and basic fibroblast growth factor in the treatment groups at different time points were stronger than those in the control group, and the expressions at 5 and 9 days were stronger than those at 3 and 14 days; percentage of cells in S phase of the treatment groups was significantly increased, especial y in 5 mg/L nerve growth factor group (P < 0.01). The results indicate that local application of nerve growth factor can accelerate wound healing by increasing the expressions of transforming growth factor β1 and basic fibroblast growth factor, stimulating mitosis and promoting proliferation.

Objective To study the validity,reliability and sensitivity of the simplified Chinese version of modified Barthel index (MBI) in evaluation of activities of daily living(ADL) of Chinese stroke patients. Methods Forty Chinese stroke patients (26 males and 14 females,aged 59.65±11.68 years) participated in the study.The duration of the disease averaged 21.20±19.44 days.All the patients were evaluated for three times with MBI.Barthel Index (BI) and the motor component of Functional Independence Measure (M-FIM)independently by twophysiatrists.Spearman correlation coefficients between MBI and Barthel index (BI),between MBI and M-FIM were used to test the validity of MBI.Intraclass correlation coefficients (ICC) were used to test both interrater and intra rater reliability of MBI.Sensitivity of MBl was analyzed with the Wilcoxon signed rank test and paired t-test.Results MBI was highly correlated with BI in each item and total score(r=0.816～1.000,P<0.01),and with M-FIM in total score(r=0.935～0.981,P<0.01).There were high reliability with MBI in the results collected by same assessor and different assessors(ICC=0.866～0.997).Furthermore,MBI was more sensitive than BI in majorities of its items and its total scores as well.Conclusions MBI has good validity and reliability as well as sensitivity in assessment of ADL of Chinese stroke patients.

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.