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. [

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 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.

A novel chemiluminescence (CL) reaction was based on the oxidizing reaction of luminol by the trivalent copper-periodate complex (K5[Cu(HIO6)2], DPC) in alkaline medium. The CL intensity could be enhanced in the presence of amikacin sulfate (AKS). A new CL method was developed for the determination of AKS by coupling with flow injection (FI) technology. Because of the distinctive oxidative effect of DPC, the luminol-based CL reaction could occur at a low concentration of 10à7 M. The relative CL intensity was proportional to the concentration of AKS in the range of 4.0 ? 10à9-4.0 ? 10à6 g/mL with the detection limit of 1.2 ? 10à9 g/mL. The relative standard deviation was 2.1% for 8.0 ? 10à9 g/mL AKS (n?9). The proposed method was successfully applied to the direct determination of AKS at the level of ng/mL in serum samples. The recovery varied from 97.0% to 106.3%. A possible mechanism of the CL reaction was discussed in detail by relating to the CL kinetic characteristics and electrochemical activities of the oxidant DPC.

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.

Objective To analyse the causes of complications and accidents of arthroscopy and a discussion of the preventive measures. Methods 1 540 cases of arthroscopy were carried out from May 1980 to May 1999, including 1 426 cases of the knee, 59 of the ankle, 17 of the wrist, 21 of the first metatarsophalangeal joint, 8 of the hip, 6 of the elbow and 3 of the shoulder. Results Surgical instruments (blade, tip of forceps) broken in the articular cavity took place in 8 cases, injury of the normal tissue including the cartilage, meniscus, and ligaments happened in 40 cases, nerve branch and vascular injured around the inlets in 11 cases, water seeping out in 13 cases, infection following the formation of hematoma in 5 cases, refracture of patella during operation in 1 case, myocardial infarction after operation in 1 case, totally, complications and accidents were seen in 79 cases (5.1％ ). Conclusion Arthroscopic complications are mainly related to unskillful manipulation of the instruments, poor team work, inadequate exposure of intra-articular structure and negligence of timely replacing the nearly worn parts of the apparatus. The complications can all be prevented by improving above mentioned points.

0.05). The duration of normoglycemia in experimental group was 23～65 days (mean 48 days), while 3～6 days (mean 5 days) in control group, with the difference being very significant between the two groups (P

Objective To preliminarily evaluate the effect of endoscopy in treatment of subcutaneous hematoma in the limbs. Methods From March 1998 to October 2001, endoscope techniques were ferformed in 7 cases of old subcutaneous hematoma, among which were 2 cases of subcutaneous hematoma on the lateral femur, 1 on the medial knee joint, 1 on the traumatic prepatellar bursa and 3 on the anterior tibia. The area of the biggest hematoma was 20 cm?5 cm and that of the smallest 4 cm?6 cm. Results All the patients were followed up with a time range of 3-16 months and got sound healing with no scar in the skin and deeper tissues, pain or dysfunction. Conclusions The endoscope for larger subcutaneous hematoma in the limbs has the advantages such as smaller incision, less scar, accurate manipulation,mild postoperative reaction and fast recovery. Therefore, it can not only obtain similar curative effect to that of the traditional open operation but also avoid the shortcomings of the traditional operation. Endoscope techniques should be the first alternative to hematoma of over 5 cm or hard subcutaneous hematoma in the limbs.