Objective To investigate the cognition level and education demand of occupational protection knowledge among nursing students in clinical practice in the hospitals of Shanghai and analyze its related factors.Methods A cross-sectional survey involving 360 nursing students was conducted in Shanghai.The survey content included occupational protection knowledge,demand and suggestions about setting up occupational protection curricula.Results The mean knowledge score was 5～13 points,with an average of (9.33±1.62)points.In multiple regression models,the level of hospital and educational status were related factors for knowledge level.The occupational protection knowledge mainly from school education accounted for 59.4％,considering it necessary to set up occupational protection curricula accounted for 60.5％.Ways of acquiring occupational protection were:teachers integrating related knowledge into teaching,receiving related education before clinical practice,and being given warning before dangerous operation,accounting for 43.7％,30.8％ and 16.2％.Conclusions Nursing students require a comprehensive foundation course in occupational protection before they enter the clinical practice.This will help to ensure their physical and mental health.

Objective To investigate the clinical efficacy of kidney-reinfocing and Du meridian-regulating acupuncture plus ginger moxibustion in treating ankylosing spondylitis. Methods Sixty patients with ankylosing spondylitis were randomly allocated to treatment and control groups, 30 cases each. The treatment group received kidney-reinfocing and Du meridian-regulating acupuncture plus ginger moxibustion and the control group, medication. After three months of treatment, the clinical therapeutic effects were compared between the two groups. Results The cure and marked efficacy rate and the total efficacy rate were 76.7%and 100.0%, respectively, in the treatment group and 53.3%and 70.0%, respectively, in the control group. There were statistically significant differences in both the rates between the two groups (P<0.05). Conclusion Kidney-reinfocing and Du meridian-regulating acupuncture plus ginger moxibustion is an effective way to treat ankylosing spondylitis.

0.05). The incidence of emergency cesarean section in borderline oligohydramnios group was significantly higher than that of the control group. Conclusions Patients with borderline oligohydramnios may have a trial of labor under intensive monitor.

AIM To evaluate the changes of serum and brain tissue endoxin in model of bilateral cerebral hemisphere ischemic reperfusion injury, and effect of anti digoxin antiserum (an antagonist of endoxin). METHODS The bilateral cerebral hemisphere ischemic model was prepared by ligating three vascular by Kameyama's manner. SD rats were randomly divided into 7 groups and each group had 8 rats. Sham group, ischemic reperfusion group, negative control group, nimodipine group, low concentration anti digoxin antiserum group, middle concentration anti digoxin antiserum group, high concentration anti digoxin antiserum group. The blood was collected at the end of reperfusion, meanwhile rats were killed, and the bilateral cerebral hemisphere were took out and used to prepare encephlon homogenate and made into samples of light microscope. RESULTS Compared with sham group, the serum CK content increased; Brain tissue SOD activity reduced and MDA content increased importantly in ischemia reperfusion group; The levels of serum and brain tissue endoxin in ischemia reperfusion group were significantly higher, while ATPase activity in brain tissue decreased; Mitochondrial Ca 2+ content in brain tissue increased significantly and Mg 2+ content decreased significantly. In brain tissue,there was some inflammatory change and local necrosis;The rank order and structure of cell wasn't clear;The morphology of pyramidal cell was abnormal. Compared with ischemic reperfusion group, Anti digoxin antiserum reduced serum CK content; It antagonized lowering of SOD activity and increase of MDA content in brain tissue; It remarkably reduced the level of brain tissue endoxin; It reduced abnormal ion content of brain tissue mitochondrion induced by cerebral ischemic reperfusion injury; The high and middle concentration anti digoxin antiserum had a significant effect on raising brain tissue ATPase activity. It reduced neuron denaturation. CONCLUSION Cerebral ischemic reperfusion can increase the level of brain tissue and serum endoxin and higher endoxin can promote brain injury. Endoxin is a major factor involved in cerebral ischemic reperfusion injury. Anti digoxin antiserum can reduce brain tissue injury and had a protective and treatment effect on cerebral ischemic reperfusion injury by antagonizing the effect of endoxin.

Objective To evaluate the reliability and validity of three-district and four-level triage standards in adult emergency department.Methods A randomized sampling cross-sectional study was conducted. A total of 1106 emergency adult patients admitted to the Second Xiangya Hospital of Central South University in Hunan Province from December 2015 to April 2016 were enrolled. The triage was independently performed by 12 nurses according to the emergency triage criteria. Based on the shift style, 2 nurses were assigned to each shift as the triage guider and assistant respectively, who did the triage for every patient independently. The clinical data were recorded as follows: the demographic data, emergency information (triage time, emergency way, complaints, vital signs, and conscious state), triage information (triage level, admitted department), waiting time, treatment time, destination and outcomes. The reliability of three-district and four-level triage standards was analyzed by Spearman correlation, and the receiver operating characteristic curve (ROC) was plotted to evaluate its validity.Results ① A total of 254 patients were enrolled for reliability evaluation in the first 2 weeks of the study. The overall internal consistency rate ofthe triage instructors and the triage assistants was 72%, the total Kappa value was 0.686 [95% confidence interval (95%CI) = 0.608-0.757,P < 0.001]. ② Validity analysis showed that in the 1125 emergency patients collected during the study, a total of 1106 patients were finally enrolled in the analysis excluding the patients who refused to accept the treatment, whose data was incomplete and who was diagnosed as prehospital death. With the increase of three-district and four-level triage level, a significant increase was showed in the waiting time of patients, the treatment time, and the retention rate; on the contrary, the salvage rate, the hospitalization rate, hospitalization time, emergency mortality, in-hospital mortality and total mortality rate were decreased [the waiting time of patients from triage level 1 to 4 (minutes) was 1.00 (1.00, 1.75), 1.00 (1.00, 5.00), 8.00 (2.00, 23.00), 10.00 (4.50, 28.00), the treatment received time (minutes) was 1.00 (1.00, 10.00), 6.00 (1.00, 23.00), 48.00 (25.00, 105.00), 87.00 (41.00, 140.00), the retention rate was 4.76%, 10.94%, 55.91%, 42.86%, the salvage rate was 95.24%, 87.94%, 20.81%, 0%, the hospitalization rate was 57.14%, 70.98%, 53.62%, 20.41%, the hospitalization time (days) was 19.50 (9.75, 28.00), 11.00 (8.00, 17.00), 12.00 (8.25, 17.00), 10.50 (8.75, 15.25), the emergency mortality was 19.05%, 6.92%, 1.41%, 0%, the in-hospital mortality was 16.67%, 15.09%, 6.25%, 0%, and the total mortality rate was 28.57%, 17.63%, 4.76%, 0%, allP < 0.05]. ROC curve analysis showed that the area under ROC curve (AUC) of three-district and four-level triage standards for identifying patients needed an immediate intervention (triage level 1 to 2) was 0.854 (95%CI = 0.831-0.878), and the sensitivity and specificity were 78.62% and 89.89%, respectively, the misdiagnosis rate was 10.11%, and the missed diagnosis rate was 21.38%.Conclusion The three-district and four-level triage standards were proved to be a reliable and valid instrument, which can distinguish the severity of the disease and help nurses to triage patients correctly.

Objective: To investigate the relationship between blood pressure, blood glucose or blood lipids and patients with cerebral infarction (CI) or intracerebral hemorrhage (ICH) in diff erent age or gender. Methods: hT e case-control study consecutively recruited patients with if rst-ever-in-a-lifetime CI (n=358) and ICH (n=230) and community-acquired pneumonia (n=165) as controls between January 2010 and December 2013 at the Second Xiangya Hospital of Central South University. hT epatients with CI or ICH were divided into the young group, the middle-aged group and the older group, and the risk factors were compared between the 3 groups. hTe patients with CI or ICH were respectively further divided into the male group and the female group. hTe blood pressure, glucose and lipids were measured. Results: Data from logistic regression models showed that CI was closely associated with high blood pressure, hypertension, diabetes mellitus (DM) or fasting plasma glucose (FPG) (P<0.05), and ICH was closely related to high blood pressure, hypertension, low density lipoprotein-cholesterol (LDL-C), FPG, serum creatinine (SCr) or alcohol drinking (P<0.05); hypertension was the main risk factor for stroke. hTe odds ratios for the young, the middle-aged and older group were 10.43, 4.74 and 7.39 respectively (P<0.05). Systolic blood pressure (OR=28.74) was the important risk factor for the young stroke, and the OR is 2.81 for the middle-aged stroke. Diastolic blood pressure (OR=2.96) and DM (OR=6.25) were the risk factor for the middle-aged stroke. LDL-C (OR=2.87) was a risk factor for the older stroke; the mean levels of diastolic blood pressure in males were signiifcantly increased compared with that in females with CI, while the mean levels of TC, HDL-C or LDL-C in females were signiifcantly higher than that in males with ICH (P<0.05). Conclusion: Hypertension, systolic blood pressure in particular, is the most common risk factor for young stroke patients. DM and hypertension are the risk factors for the middle-aged patients, while hypertension, DM, LDL-C and alcohol consuming are the risk factors for the aged patients.

Humans ; Liver Cirrhosis ; diagnosis

BACKGROUND: Caspase-3 is well recognized as the key caspase carrying out apoptosis in animal and human brain. To date, a few studies revealed the expression of caspase-3 protein in brains of normal persons and Alzheimer patients but data obtained from rodents exhibited much discrepancy.OBJECTIVE: To investigate the different expression patterns of caspase-3in rodent and monkey brain, and the different expression of caspase-3 in different brain regions and during aging in monkeys.DESIGN: Parallel comparison between means of single variable.SETTING: Institute of Hepatobiliary Surgery, Chinese PLA General Hospital and Department of Anatomy, the Chinese University of Hong Kong.MATERIALS: The experiment was carried out from August, 2003 to February, 2005 in Institute of Hepatobiliary Surgery, Chinese PLA General Hospital and Department of Anatomy, the Chinese University of Hong Kong. Sprague Dawley rats, ICR mice and senescence-accelerated mice (SAM) with ages ranging from postnatal 2, 12, 24 to 48 weeks(n=5 for each age group of different rodents) were included in the present study. All of these animals were supplied by Laboratory Animal Services Center, the hinese University of Hong Kong. Totally 8 rhesus monkeys aged 4 years (n=4) or 20 years (n=4) were selected from the Laboratory Animal Center in Chinese PLA General Hospital [SCXK-(Beijing)2003-002]. Both ro dents and monkeys were female and were raised under standard conditions without any experimental interventions. METHODS: ①Brain tissue samples were taken freshly from both rodents and monkeys and made into homogenate. The expression of caspase-3 pro tein in brains of both rodents and monkeys was investigated with im munoblot. ② The expression levels in monkey brains were exhibited quantitatively with the same method in three brain regions, such as the frontal cortex, hippocampus and cerebellar cortex, for the two age-groups. In vivo distribution patterns of caspase-3-immunoreactive cells were further presented in 3 brain regions of monkeys through immunohistochemistry. MAIN OUTCOME MEATURES: ①Detection of caspase-3 protein with immunoblot in the brain of rodents and monkeys; ② Distribution patterns of caspase-3-immunoreactive cells in 3 brain regions of monkeys. RESULTS: ① Result of detection with immunoblot: The same pattern of caspase-3 protein expression in brain of three kinds of 2-week-old rodents. But the expression was not seen in any other brains of older ages. Caspase 3 was expressed in a relatively high level inboth adult and aged monkey brains, and the amount did not attain to the level in 2-week-old rodents. Caspase-3 Was expressed in the pattern of zymogen (Mr 32 000). The ex pressions of caspase-3 in brains of monkey were not different in ages and brain regions. ②Result of Immunohistochemistry: It was showed that most neurons in the frontal cortex lack detectable caspase-3 immunoreactivity, whereas low to moderate caspase-3 immunostaining be found mainly in pyramidal cells in CA1, CA3 and CA4 subfields of hippocampus. And in the cerebellum, a small number of Purkinje cells were strongly stained in their cytosol and dendrites. Age-related expression pattern of caspase-3 were not found except that in the motor cortex of aged monkeys in which there were a limited number of large pyramidal cells in layer Ⅴ that were strongly stained with caspase-3 antibody.③ Immunoblot procedure revealed that the caspase-3 protein expressed in monkey brains is in the form of zymogen (Mr 32 000) and there is no significant difference in caspase-3 expression level as a function of either brain region or age of animals.CONCLUSION: Unlike rodents in which caspase-3 protein rapidly drops to an undetectable level since animals grow up, the primate expresses caspase-3 constitutively in brain until the late period of lifetime. But there are no significant brain region- or age-related differences in the protein levels in monkey brain.

Objective To explore the function of scavenger receptor class B type I(SR-BI)in the human peripheral blood monocyte expression of proinflammatory cytokines mRNA induced by oxidized low density lipoprotein(OxLDL). Methods With the digoxenin-labeled oligonucleotide-probes in situ hybridization, we investigated the effects of OxLDL, fucoidin and 17?-estradiol on the primarily-cultured human peripheral blood monocyte mRNA expression of SR-BI and relationship between its expression and the mRNA expressions of MCP-1, bFGF, PDGF and IL-10. Results The mRNA expression of SR-BI was significantly increased in a dose-dependent manner after incubating with OxLDL (10～30 mg?L -1)(P

Objective:To investigate the function of oxidized low density lipoprotein(OxLDL) in the formation of atherosclerotic immuno-pathological lesions in the local blood vessel.Methods:With the Digoxenin-labeled Oligonucleotide-probes In Situ Hybridization,studied the effects of OxLDL on the mRNA expression of proinflammatory cytokines including MCP-1, bFGF, PDGF and IL-10 in the human peripheral blood monocyte. Results:Monocyte was significantly increased the mRNA expression of MCP-1, bFGF, PDGF and IL-10 in a dose-dependent manner after incubating with OxLDL(10～30 mg/L)for 24 hours(P