Objective To explore the effect of empathy nursing on the anxiety and nursing satisfaction of cesarean parturients.Methods Seventy-two cases of cesarean parturients treated in our hospital between September 2013 and October 2014 were selected as the study object.These women were randomly divided into an observation group and a control group,with 36 cases in each group.Those in the control group were given routine nursing and those in the observation group were given routine nursing and empathy nursing.Results After nursing,the anxiety and depression of patients in both groups were alleviated.The anxiety score and depression score in the observation group were respectively (31.16 ± 3.94) and (18.21 ± 2.97),lower than those in the control group,with the anxiety score of (43.19 ± 4.45) and the depression score of(43.19 ± 4.45) The differences between the two groups were statistically significant (P＜0.01).After nursing,improvement on life quality of the patients was registered in both groups.The scores of cognitive function,physical function,emotional function,role function and social function of patients in the observation group higher than those in the control group.The comparative difference was statistically significant (P＜0.01).Besides,the total score of nursing satisfaction in the observation group was (118.53 ± 12.41),significantly higher than that in the control group which was (97.65 ± 6.81),and the difference was statistically significant (P＜0.01).Conclusion For cesarean parturients,empathy nursing can better help to identify the patients' psychological changes and to establish closer bond between the nursing staff and the patients,which can provide guidance for them to cultivate positive mental state,help the staff to better understand their needs,pains and their pressure,thus lessen their anxiety and improve the nursing effect and satisfaction.

Objective To find out about the status quo of the contingent of pharmacists in medical institutions of Shanghai so as to provide basis for promoting reform in the mode of pharmacological work in the hospital and adopting the system of clinical pharmacists. Methods An investigation through questionnaires was made into over 6 000 pharmacists from 416 hospitals(28 third-tier hospitals, 52 second-tier hospitals, and 336 first-tier hospitals) with respect to their professional titles, educational backgrounds, and distribution of posts. Results On average, the number of personnel with senior or medium professional titles in third-tier hospitals was markedly higher than that in second- or first-tier hospitals; people with doctoral or master's degrees were distributed mosdy in third-tier hospitals; the proportion of personnel with senior or medium professional tides on emergency outpatient posts in second- or third-tier hospitals was lower than diat in other departments; and on average, the number of resident pharmacists per hundred beds was less than one. Conclusion There is a drastic shortage and unbalanced distribution of personnel with senior or medium professional titles in the contingent of pharmacists in Shanghai and the structures of the professional tides and educational backgrounds of the pharmacological personnel lag behind the needs for clinical pharmacological services. Efforts must be made to improve the overall quality and expertise of the contingent of pharmacists so as to get ready in terms of qualified personnel for the adoption of die system of clinical pharmacists.

Objective To investigate the protective effect of glutamine(Gln) pretreatment on intestinal ischemia-reperfusion (I/R) injury and endothelial nitric oxide synthase (eNOS)/nitric oxide (NO) signaling pathway in rat model. Methods Thirty male Wistar rats were randomly divided into three groups(n=10 for each group):sham group, I/R group and Gln group. Animals were pretreated with 1 g/(kg·d)Gln by orogastric route for 7 days in Gln group, and normal saline was given to the other two groups in the same dose. Intestinal I/R was induced by 30 min occlusion of the superior mesenteric artery followed by 24 h of reperfusion. After the operation, the intestinal histopathological changes, the plasma endotoxin level, serum D-lactic acid, eNOS, inducible NOS(iNOS)activity and NO levels were detected by ultraviolet spectrophotometer. The mRNA expressions of myocardial eNOS and iNOS were detected by real-time fluorescence quantitative PCR (RT-PCR). Results After reperfusion, in IR group, extensive epithelial sloughing and mucosal ulceration of villous tips were observed, whereas these findings did not occur in Gln group and sham group. Compared with IR group, the serum NO, eNOS levels and eNOS mRNA expression of intestinal tissue were elevated in Gln group (P<0.01), but the plasma endotoxin level, serum D-lactic acid, serum iNOS and intestinal iNOS mRNA expression decreased in IR group(P<0.05). Conclusion Glutamine pretreatment has protective effects on intestinal ischemia-reperfusion injury in vivo. The mechanism may be related to the inhibition of iNOS expression and the increased expression of eNOS, thereby increasing NO activity.

BACKGROUND:The embryonic epicardium can differentiate into myocardial cells and the cardiac stem cells with the potential of vascular smooth muscle cells, and it can differentiate into cardiac three-line cells which provide a new cellsource for the regeneration of cardiac injury. But the directed differentiation mechanisms and regulatory factors are stil unclear. OBJECTIVE:To establish the in vitro culture model of epicardial cells of mouse embryonic heart. METHODS:Embryonic hearts were dissected from the mice at pregnant 10.5-11.5 days, and the pulmonary veins, atrial tissue and left ventricle were cut off, then the embryonic hearts were transplanted into the 6-wel plates (or 35 mm dish) for culture. After cultured for 24 hours, the embryonic heart tissues were removed and cultured continuously. Phase contrast microscope was used to observe the growth characteristics of embryonic epicardial cells;the immunofluorescence technique was used to stain the specific antibody Wt-1 and Tbx18 of embryonic epicardial cells. RESULTS AND CONCLUSION:The embryonic epicardial cellmonolayers grew from tissue block edge with cobblestone-like and extended outwardly around the tissue blocks. After removed the embryonic heart, the cells grew continuously with rapid proliferation, and got fusion at 34 days. Al the embryonic epicardial cells could positively express the specific antibody Wt-1 and Tbx18 of embryonic epicardial cells. The results indicate that embryonic epicardial cells have the characteristics of rapidly growth and uniform morphology, and can express the embryonic epicardial cellspecific antibody with high purity. The successful y constructed in vitro culture models of embryonic epicardial cells provide new idea for the molecular mechanisms of directed differentiation.

Objective To investigate the clinical value of multi-slice CT angiography (MSCTA) of lower limbs in patients with peripheral arterial occlusive disease (PAOD) using the test-bolus technique.Methods Forty-four patients with PAOD were enrolled consecutively in the study.In group I, 18 subjects underwent CTA by bolus triggering method and in group 2, 26 subjects underwent CTA by test-bolus technique.During scanning procedure in group 2 subjects, the bolus transit time to aorta ( TAO ), popliteal arteries (Tpop ) and aorto-popliteal bolus transit time (T,) were calculated through dynamic acquisition at their respective level and the delay time were immediately set as TAO and scan time as double Tt.Two independent senior attending physicians with training experience in interpreting CTA determined the quality of each arterial segment visualization based on 5 parameters (1.visible farthest branch, 2.clarity of vessels border, 3.presence of venous contamination, 4.grading of stenosis, 5.CT value at 4 arterial segments).Inter-observer agreement on imaging quality between readers was evaluated using Cohen's k statistic by calculating K values.X2 test and t test were used to compare the quality of images in both groups.Results In group 2 patients,a larger individual variation in transit time of the contrast to reach aorta was obserued [ TAO = ( 17.1 ± 2.6) s with a range of 12.0—22.0 s ] and aorto-popliteal transit time [ Tt = ( 14.8 ± 5.5 ) s with a range of 8.0—24.0 s ].CTA of group 2 patients demonstrated bettor quality over group I patients' CTA, especifieally in the infra-pop|iteal and foot area arteries. There was an excellent inter-observer agreement for group 2 patients ( K ＞ 0.80 ) whereas in group 1 agreement in infra-popliteal segments for venous contamination ( K value 0.60 ) and stenosis degree ( K value 0.50 ) were not satisfactory enough.Group 1 patients were reported to have more severe stonosis in infra-popliteal and foot arteries( X2 = 30.55 and22.41,P＜0.01).Conclusion There was a wide interindividual variation in transit time for contrast medium to reach aorta and pollteal artery. Adaptive method by using two low-dose test bolus injection determined interindividual variation in delay time and scan time and thus above parameters was able to produce better quality images than using bolus triggering technique in below knee and foot region arteries.

Objective To investigate the effects of isoliquiritigenin on the invasive ability of human gastric carcinoma SGC7901 cells, and its molecular mechanisms thereof. Methods The logarithmic phase human gastric carcinoma SGC7901 cells were divided into control group (normal cell culture fluid) and isoliquiritigenin group (isoliquiritigenin solu?ble in cell culture fluid, the concentrations were 10, 25, 50 and 100 μmol/L respectively). Each group had four repeated holes. The proliferation of SGC7901 cells were detected with MTT assay after 24 h, 48 h and 72 h of culture. The experimen?tal drug concentration and action time were researched for the subsequent experiments. The in vitro invasion abilities of SGC7901 cells were assessed with Transwell test. The expression levels of MMP9, Akt and P-Akt were detected by Western blot assay. Results The proliferation of SGC7901 cells were inhibited by 10μmol/L isoliquiritigenin, which can be signifi?cantly inhibited by 25, 50 and 100μmol/L isoliquiritigenin in a concentration-dependent and time-dependent manner. The half inhibitory concentrations (IC50) of 24, 48 and 72 h were 52.48, 44.49 and 32.50μmol/L, respectively. Therefore, the 25, 50 and 100μmol/L isoliquiritigenin were selected as the subsequent experimental drug concentration, and 24 h was used as the action time. Compared with the control group (209.75±9.29), the membrane cell number of 25μmol/L (138.50±10.15), 50μmol/L (89.50 ± 16.56) and 100μmol/L (45.00 ± 8.08) decreased gradually (F=267.948,P<0.05). There was no signifi?cant difference in the expression level of Akt protein between four groups (F=1.492). The expression levels of P-Akt and MMP9 were gradually decreased with the increase of the isoliquirigenin concentration (F=359.219 and 431.324,P<0.05). Conclusion Isoliquiritigenin can obviously inhibit invasion ability of SGC7901 cells, which may be related to the down reg?ulation of the signal transduction pathway protein PI3K/Akt and the down steam protein MMP9.

Objective To evaluate the echocardiographic features of coronary artery dilation (CAD) and coronary artery aneurysms (CAA) in Kawasaki disease dynamically.Methods Echocardiography was performed in KD cases for measurement of the diameter of the coronary artery.Results Twelve CAD and four CAA were identified in forty-one patients.In CAD group,left coronary artery (LCA) is more susceptive to dilation than right coronary artery (RCA)(P<0.05).Both LCA and RCA were involved in CAA group,the maximum diameter of coronary artery is 10mm.Six to eighteen days after treatment,LCA were regressed significantly in CAD group(P<0.05),but the diameter of RCA in CAD group and coronary artery in CAA patients have no change(P>0.05).Ten coronary artery lesion patients were followed up,8 CAD cases regressed completely,1 CAA extended,the other CAA regressed completely.Conclusions In CAD group,LCA is more susceptive to dilation than RCA,but it regressed significantly in a short time after treatment.Echocardiography is a non-traumatic method to detect the coronary artery lesions in KD patients dynamically.

Objective To analyze the clinical features, diagnosis, treatment and prognosis of neurosyphilis. Methods Clinical data on and laboratory findings in 18 cases with neurosyphilis collected in the Affiliated Provincial Hospital, Anhui Medical University from 2006 to 2008 were retrospectively studied.Results Among the 18 patients, 3 sufferred from asymptomatic neurosyphilis, 1 from meningeal syphilis, 7 from meningovascular syphilis, 5 from paralytic dementia, and 2 from intracranial space-occupation. Toluidine red unheated serum reagin test (TRUST) and Treponema pallidum particle agglutination test (TPPA) of sera were positive in all the patients; cerebrospinal fluid (CSF) TRUST was positive in 16 patients, and CSF TPPA in all patients. An increase was observed in CSF leukocyte count in 7 patients and in CSF protein in 13 patients.The findings on cerebral magnetic resonance imaging (MRI) mainly included demyelination, brain atrophy,cerebral infarction, etc. All the patients, except 2 with a TRUST titer of 1:4, experienced a 4-fold decrease in TRUST titer within a 3-month follow up. Clinical symptoms of neurosyphilis improved in all patients except 1 with paralytic dementia. Conclusions The diversity of clinical manifestations usually leads to the misdiagnosis of neurosyphilis, which should be diagnosed based on comprehensive analysis of clinical characteristics as well as laboratory and imaging findings. Early diagnosis and treatment are beneficial to its prognosis.

Objective To examine the correlation of imbalance of urinary exosome Th1/Th2 with diabetic nephropathy (DN).Methods A total of 120 patients with type 2 diabetes mellitus (DM) and 30 healthy volunteers as control were enrolled in the study.According to urinary albumin/creatinine ratio (UACR),type 2 diabetes mellitus patients were divided into 3 groups:diabetes mellitus without nepbropathy group (DM,n=40,UACR＜30 mg/gCr),microalbuminuria group (DN 1,n=50,UACR-30～300 mg/gCr) and clinicoalbuminuria group (DN 2,n=30,UACR＞300 mg/gCr).Urine exosome-interferon-gamma (IFN-γ) and exosome-interleukin 4 (IL-4) levels were determined by enzyme-linked immunosorbent assay (ELISA).Multiple stepwise linear regression was used to analyze the correlation of exosome-IFN-γ/IL-4 with glycated hemoglobin (HbA1c),cholesterol (CH),UACR,Scr and BUN.Results Th1/Th2 ratio in DM,DN1,DN2 groups was significantly higher than that in healthy group (0.8089±0.2458,0.8993 ±0.3515,0.8571±0.2470 vs 0.6198±0.1769,all P＜0.01).Correlation analysis showed that urinary exosomeIFN-γ/IL-4 ratio was positively correlated with UACR (r=0.213,P=0.015) and BUN (r=0.292,P=0.001).Multiple stepwise linear regression analysis showed that BUN was independent determinants for exosome-IFN-γ/IL-4 (β=0.246,P=0.006).Conclusion The imbalance of urinary exosomeTh1/Th2 is correlated with DN,which may play an important role in the pathogenesis of DN.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.