50 tracheotomy patients with mechanical breathing were performed respiratory tract control for suitable breathing. Result 5 patients recovered and had spontaneously breathing without respirator in 3~5days, then the trachea cannulas were pulled out in 1~2 weeks. Conclusion effective respiratory tract control may enhance the curative rate and improve patients' life quality.

Objective To understand the subjective perception and influential factors of physical assessment technique in clinical nurses. Methods Using self-designed physical assessment skills questionnaire to investigate nurses in the six provinces of China, 1115 questionnaires were valid. Results There were 11 items in this questionnaire. The first four were: physical assessment is an essential skill of nurses (88.1%),the importance of continuous learning (84.8%), lack of maturity assessment tools (79.8%), heavy workload,lack of time (60.8%). The result of multiple regression analysis (stepwise) showed that hospital-level and regional were the main factors affecting the subjective perception. Conclusions The development of physical assessment reies mainly on rational allocation of human resources structure, establishing the physical assessment framework, and make sure different departments have their own characteristics and the importance of continuing education.

Objective To understand the application status of physical assessment in clinical nurses. Methods Using self-designed physical assessment skills questionnaire to investigate nurses in six provinces of China, 1115 questionnaires were valid. Results There were 171 items in this questionnaire,4.0% of them were used regularly, 19.3% used frequently, 76.7% used occasionally. The result of Spearman correlation showed that there was positive correlation between the frequency of physical assessment skills and the subjective needs of nurses, regional, educational background, hospital level. There was also negative correlation with title, age and seniority. Conclusions The main factors lead to imbalance development of physical assessment skills are regional, hospital-level and education background; the assessment skills of specialist hospitals and wards need to be standardized immediately.

OBJECTIVE:To establish a method for the contents determination of volatile components in Huodan pill and study the effects of 60Co irradiation with different doses on the volatile components in Huodan pill. METHODS:GC-MS was used to de-termine the contents of patchouli alcohol and the ralative contents of β-patchouliene,α-guaiacene,seychellesene,α-patchouliene,α-bulnesene,5,11-diene guaiacyl,and unidentified objects in Huodan pill after 60Co irradiation with different doses. Column was HP-5MS by programmed temperature,volume temperature was 250℃,split ratio was 50:1,detector was triple quadrupole mass spectrometer detector,MS1 quadrupole temperature was 150℃,MS2 was 150℃,carrier gas was helium,flow rate of column was 1.2 ml/min,and the volume injection was 1 μl;ion source was EI,bombarding energy was 70 eV,temperature of ion source was 230℃,temperature of transmission line was 280℃ and scan range was 50-500 amu. RESULTS:The linear range of patchouli alcohol was 0.103 1-2.062 0μg(r=0.999 4);RSDs of precision,reproducibility and stability tests were lower than 1.0%;recovery was 98.05%-102.32%(RSD=1.8%,n=9). 60Co irradiation with different doses had little effects on the 8 volatile components in Huodan pill. CONCLUSIONS:60Co irradiation can be used for sterilization on Huodan pill,but irradiation dose should be controlled. The method is simple,good reproducibility,and can be used for the contents determination of volatile components in Huodan pill.

Objective To evaluate the safety and effect of embryo aspiration and fetal cardiac activity area injection of transvaginal pregnancy multi -fetal reduction for women with early pregnancy.Methods Retrospective a-nalysis of 120 cases with transvaginal early pregnancy multi -fetal reduction was conducted.The pregnancy outcome of the two ways was analyzed and evaluated.Results Among 120 cases,55 cases were treated with fetal cardiac activity area injection,65 cases were treated with embryo aspiration.Fetal cardiac activity area injection group:gestational age (48.7 ±9.1)d,postoperative infection abortion rate:12.7% (7 cases),rate of premature babies:5.5% (3 cases). Embryo aspiration group:gestational age (46.9 ±4.2)d,postoperative infection abortion rate:6.2% (4 cases),rate of premature babies:3.1% (2 cases),the difference between postoperative infection abortion rate was statistically sig-nificant (P =0.02).Virgiria Apgar score (P =0.41),neonatal weight(P =0.70),fetal malformation rate (P =0.24),neonatal move to NICU rate (P =0.83),the differences were not statistically significant.Conclusion During the early stage embryo aspiration is a safe method for the multi -fetus reduction,the pregnancy outcome is better than fetal cardiac activity area injection.

Hereditary diffuse gastric cancer (HDGC) is an autosomal dominant inherited disease,and may be related to the mutation of CDH1 or CTNNA1 genes.Microscopically,signet-ring cell carcinoma is suggested frequently in endoscopic biopsy or gastrectomy specimens.Some patients may have concomitant extra-stomach tumor (frequently breast cancer in females).Detection of CDH1 gene mutation should be performed in high-risk individuals,and diagnosis and treatment should be carried out by a multidisciplinary team.Prophylactic gastrectomy is recommended for those with pathogenic CDH1 mutation.Endoscopic surveillance is an option for those with CDH1 mutation of undetermined significance and those without germline CDH1 mutation.This review discussed the concept,genetic characteristics,clinicopathological features and genetic screening of HDGC for providing a reference for clinicians.

ObjectiveTo testify the therapeutic efficacy of acupuncture in treating diarrhea-predominant irritable bowel syndrome (D-IBS) based on brain-gutinteraction.MethodEighty D-IBS patients were randomized into brain-gut interacted acupuncture group (treatment group) and a group with acupoints selected based on conventional syndrome differentiation (control group), 40 in each group. The treatment group was intervened by acupuncture by selecting the thirteen ghost acupoints (invented by SUN Si-miao) plus Tianshu (ST25), Dachangshu (BL25), etc., while the control group was by acupuncture based on conventional point selection, including Zusanli (ST36),Tianshu (ST25), Dachangshu (BL25), Ganshu (BL18), Pishu (BL20), etc., three times a week, and 10 sessions as a treatment course. The clinical efficacies were evaluated after 2 treatment courses.ResultThe two groups were generally equal to each other incomparing each dimension of the Short-form Health Survey (SF-36) before treatment, while the scores were increased after treatment in both groups; the treatment group was significantly superior to the controlgroup in comparing the scores ofrole-physical,bodily pain, general health, vitality, social role functioning, and reported health transition from the SF-36 (P<0.05).ConclusionAcupuncture based on brain-gut interaction can produce a more significant effect in treating D-IBS compared to conventional acupuncture.

Objective To observe the effect of penetrating needling with thick needle at Shenzhu (GB 12) on the Unified Parkinson’s Disease Rating Scale (UPDRS) score in patients with Parkinson’s Disease (PD). Methods Sixty-one PD patients were randomized into a treatment group of 31 cases and a control group of 30 cases. The treatment group was intervened by penetrating needling with thick needle at Shenzhu (GV 12) in addition to oral administration of Levodopa and Benserazide Hydrochloride;while the control group was by oral administration of Levodopa and Benserazide Hydrochloride alone. The UPDRS was evaluated before and after intervention in both groups. Results Respectively after 30-day treatment, 90-day treatment, and 90 d after the intervention, the UPDRS scores were significantly changed compared to that before intervention in both groups (P<0.01, P<0.05);there were also significant differences in comparing the UPDRS score between the two groups at each time point (P<0.01, P<0.05). Conclusions Penetrating needling with thick needle at Shenzhu (GV 12) can improve the UPDRS score in PD patients, and it’s an effective method in treating PD.

Leukemia is a malignant hyperplasia disease of hematopoietic system. It is characterized that a certain blood cell system proliferates, gets into blood streaming, infiltrates each organism and apparatus and arouse a series of clinical manifestation. In recent years the study of leukemia has discovered that it was correlated with apoptosis of the cells. The roles of XIAP and survivin in apoptosis inhibition have been especially paid attention. It is discovered that they play major roles in the genesis and resistance to chemotherapeutical drug of tumors. We summarize the biological characteristics and the expressions of XIAP and survivin in the children with acute leukemia.

Kallikrein-kinin system consists of kininogen , kallikrein, bradykinin and kinin .Kinins, derived from kininogen by tissue kallikrein , play their biological effects via bradykinin 1/2 receptors or protease activated receptors .Existing researches suggest that kinins exert various effects through different intracellular and mitochondrial signal pathways such as MAPK , PI3K/Akt/GSK3 be-ta, NO, JAKs/STATs.This review aims to elucidate the roles and the intracellular signal pathways of KKS in different diseases .