Objective To investigate and compare the clinical efficacy and safety of laparoscopic and traditional open surgery in the rectal cancer surgery.Methods From March 2007 to February 2013,86 patients with radical resection of rectal carcinoma in General Surgery Department of Pinggu District Hospital of Beijing were selected as research objects,according to random number table method,they were divided into laparoscopic group(n=43) and laparotomy group(n=43).The laparoscopic group was given laparoscopic radical resection of rectal cancer,the laparotomy group was given traditional open surgery.The baseline data,operative incision length,intraoperative blood loss,operative time,postoperative hospital stay,total number of lymph nodes cleaning,exhaust time,time to get out of bed,hospitalization expenses,VAS score and postoperative complications between the two groups were observed and compared.And the survival rates of the two groups were compared.Results.The operative incision length of laparoscopic group was shorter than laparotomy group((4.20±1.15) cm vs.(16.53±4.62) cm),the intraoperative blood loss was less than laparotomy group((167.43±16.24) ml vs.(220.74±22.53) ml),postoperative hospital stay,exhaust time,time to get out of bed were shorter than laparotomy group((8.26±2.09) d vs.(13.52±2.97) d,(3.24±1.42) d vs.(4.23±1.60) d,(3.07±0.84) d vs.(4.23±1.29) d),the hospitalization expenses was higher than laparotomy group(all P<0.05).The VAS score and postoperative complication rate of laparoscopic group were lower than laparotomy group((5.32±1.18) points vs.(8.16±1.25) points,2.33%(1/43) vs.20.93%(9/43),P<0.05).There were no significant differences inoperative time and total number of lymph nodes cleaning between the two groups(P>0.05).The 5 year overall survival rate of laparoscopic group was 52.6%,the laparotomy group was 47.4%,there was no significant difference between the two groups(χ2=0.465,P>0.05).Conclusion The clinical efficacy of laparoscopic and traditional open surgery in the rectal cancer surgery are the same,and laparoscopic radical surgery is safe and effective,it has the advantages of less trauma,less complications and quick recovery,is worth popularizing.

Objective To investigate the charge nurses' leadership style perceived by nurses and nurse's self-efficacy,and then analyze the relationship between them.Methods Totally 368 staff nurses from 3A hospitals in Sichuan were investigated with questionnaires.The results underwent analysis.Results The score of charge nurses' transformational leadership style was 58.06±12.10,from high to low in turn was intellectual stimulation (3.10±0.69),inspirational motivation (2.92±0.73),idealized influence (2.88±0.67) and individualized consideration (2.71±0.74).The score of charge nurses' transactional leadership style was 35.77±8.58,from high to low in turn was contingency reward (3.11±0.71),passive exemplary management (3.09±0.75) and active exemplary management (2.75±0.90).The score of nurses' self-efficacy was 83.51±11.62.The transformational leadership style had positively predictive impact on nurses' selfefficacy.Conclusions Nursing managers should apply transformational leadership to improve nurses selfefficacy,promote the physical and mental health of nurses and the long-term development of hospital.

Objective To investigate the calbindin D\|28K (CB) neurons that receive the visceral nociceptive information in the interstitial nucleus of the spinal trigeminal tract (INV) directly project to the nucleus of the solitary tract (NTS). Methods Triple\|labeled methods of fluorogold (FG) retrograde tracing combined with Fos and CB proteins immunofluorescence histochemistry after formalin stimulating upper alimentary tract. Results Most of FG\|retrograde labeled neurons distributed in the paratrigeminal nucleus (PaV) and the dorsal paramarginal nucleus (PaMd) of INV ipsilateral to the FG injection. About 71\^2% of FG\|retrograde labeled neurons contained CB and 31\^5% of FG/CB double\|labeled neurons exhibited positive Fos\|immunoreaction in INV.Conclusion The results suggested that a part of neurons containing CB in INV receive the visceral nociceptive information and directly project to NTS. CB neurons might play an important role in transmitting visceral nociceptive information from INV to NTS. [

Objective To analyze the trend of nursing information system(Nursing Information System,NIS) and contemporary situation,so as to provide a reference for the further development of NIS in China.Methods Based on China Academic Journal Network Publishing Database,Wanfang database and VIP Chinese academic periodical database,retrieval published NIS literature from 2009 to 2013 in China.Seven aspects were analyzed:time,areal distribution,cooperative rate,authors,institutions,periodicals and keywords.Results There were 438 articles from 128 published journals,47.9％ papers were in the statistical source journals.Research content mainly involved clinical nursing and nursing management.Conclusions NIS research has achieved great development in the past 5 years,but the researches should be strengthened in breadth and depth.

Objective To investigate the tissue structure of the human scalp hair follicles,the ability of hair follicle regeneration in vitro and the influence elements of growth and proliferation of follicle organ.Methods The paraffin sections of the 15 cases of human scalps and 150 cases of scalp hair follicle tissues were prepared,and morphological characteristics and organizational structures was observed by HE staining.The experience and growth pattern of the hair follicle that was cultured in Williams E medium in vitro were summarized.Results Human scalp contained a large number of hair follicles and sebaceous glands,sweat glands,and other skin accessories.Epithelial cells were rich in hair follicles and poorly differentiated in structure,and grew in the regular direction in scalp tissue.The Williams E was used to culture successfully human scalp hair follicles.Hair follicles grew with the fastest speed in the first 5 days.Compared with other media,the use of serum-free Williams E medium in the hair follicle in vitro experiments achieved better results.Conclusions Human scalp contained a large number of hair follicles and sebaceous glands,sweat glands,and other skin accessories.Williams E medium without serum medium was more conducive than other medium for hair follicle culture in vitro,so that regeneration of hair follicles in vitro with a better capacity created favorable conditions for the delay in hair transplant surgery.

Objective To analyze the situation of medical social support and self-perceived burden in elderly patients with chronic obstructive pulmonary diseases (COPD) in Chengdu,explore the influence of medical social support for patients with family oxygen cure.Methods A convenient sampling was conducted in 4 hospitals in Chengdu,and selected totally 124 elderly patients with COPD in January 2013 as the research object.Results Those patients' average daily life ability score was (20.19 ± 7.10) points,42 cases' daily life ability was normal,44 had deficiency in daily life,38 had obvious flaws;16 cases received medical social support condition at a critical level,66 at a general level,42 in good condition;the difference of the ability of daily life between actual support and other supports was statistically significant (P＜ 0.05);the difference in patients with self-perceived burden and medical social support was not statistically significant (P ＞0.05).Patients with long term oxygen therapy had higher self-pereeived burden than patients without oxygen therapy at home [(18.65±3.97) points vs.(17.69±6.24) points,t=6.015,P＜0.05],but patients with long term oxygen therapy had better medical and social support condition than those without oxygen therapy at home [(282.11±37.47) points vs.(262.26±61.14) points,t=6.624,P＜0.05].Conclusions The level of medical and social support in elderly patients with COPD need improve.Nurses need to provide better guidance for patients with long term oxygen therapy,ensure them obtain adequate information,improve their emotional support and social interaction,enhance their medical social support condition.

The treatment of recurrent head and neck cancers has improved from single modality interventions of surgery and radiation therapy alone to include combined modality therapy with surgery, chemotherapy and radiation. Combined therapy has led to improved local control and disease-free survival. New developments in radiation oncology such as intensity-modulated radiotherapy, brachytherapy, stereotactic radiosurgery, fractionated stereotactic radiotherapy, have helped to improve this outlook even further. These recent advances allow for a higher dose to be delivered to the tumor while minimizing the dose delivered to the surrounding normal tissue. This article provides an update of the new developments in radiotherapy in the management of previously-irradiated recurrent head and neck carcinoma.

Objective To study the feasibility of laparoscopic total mesorectal excision(TME) for low rectal cancer.Methods Laparoscopic total mesorectal excision was performed in 126 patients with low rectal cancer according to TME principle.Results The operation time was 95 - 180 min,with an average time of ( 117 ± 21 ) min,the amount of bleeding 50 - 200 ml,with an average amount of (90 ± 27 ) ml.2 - 3 days after surgery,gastrointestinal function was restored.Hospital stay was 6 - 14 days,with an average of (8 ± 2)days.Four cases converted to open surgery,the conversion rate for laparotomy was 3.2％.The proportion of sphincter-preserving operation was 95.24％ (120/126).No instant or delayed injury of ureters,large bleeding in front of sacrum and other operation-related severe complications happened intra-and after operation.Conclusion Laparoscopic surgery for low rectal cancer is safe and feasible.

Objective To understand status quo of the domestic and foreign iceberg competency model application,and to provide basis for further study in the nursing iceberg competency model.Methods A literature review about the application of competency iceberg model at home and abroad since 2009 was carried out,the relevant data was listed,and the research situation of domestic and foreign nursing iceberg competency model was summarized.Results According to the 141 total literatures whose theme was the iceberg competency model,only 3 articles were related to the nursing field,while most of the iceberg competency model aimed at the study of enterprises in the high-level management personnel,sales personnel and so on.More researches on competency iceberg model were conducted abroad,involved in all walks of life,an research direction of nursing had turned from general iceberg competency model to the study of specific posts.Conclusions The iceberg competency model applied to the management of nursing human resources in China is developed lately and the studies lack breadth,depth and scientificalness.Compared with foreign countries,there is a big gap.A thorough iceberg competency model for human resource management is ought to be studied to provide a new perspective and a more useful tool for the early Chinese nursing theory and practice.

[Objective] To enhance the understanding of the diagnosis of benign tumor in the knee joints.[Method] Thirteen patients(9 males and 4 females,aged 7 to 49 years,38.2 years arerage)with tumor in the knee joints were diagnosed and treated under arthroscopy since 1996.There were 3 with the synovial hemangioma,2 with tensoynovial giant cell tumor,4 with ganglion cysts of cruciate ligament and synovial cysts,1 with chondroma in the soft tissue,2 with desmoid tumor in the cruciate ligament and 1 with cruciate ligament desmoid.The curative effects were observed through a follow-up of more than half a year.[Result]All the cases were diagnozed under arthroscope and confirmed by the pathological examinations.All the patients were treated under arthroscope and followed by 11 months to 6 years.Clinical symptom improved obviously and no recurrence was found after the operation.Assessment of the curative effects were 46% excellent,39% good and 15% fair.[Conclusion]Benign tumor in the knee joints is rare.It's often difficult to diagnoze in the clinical practice.Arthroscopy is a very useful method for the diagnosis and treatment of the suspected patients with benign tumor in knee joints.