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.

Humans ; Liver Cirrhosis ; diagnosis

Objective To establish a reproducible and controllable experimental swine model of abdominal multiple organ trauma.Method Fifteen pigs were included in the present study,and the method adopted conformed to the animal ethics.With the self-made explosive device,the electric firecrackers consisting of 0.3g,0.2g and 0.2g black powder were put respectively onto the surface of left lateral lobe of liver,lower pole of spleen and tail of pancreas to produce injuries by explosion.The operation time of exploratory laparotomy and isolation of the organs,blood loss,the maximum diameter and area of injury to the liver and spleen due to explosion,the length and extent of the pancreas that was injured in explosion,as well as the changes in mean arterial pressure(MAP) during the operation were detected and recorded.Finally,the injury severity score(ISS) was calculated.Results The damaged liver area was 9.2?0.3cm2,the maximum diameter of damaged liver was 5.4?0.2cm,the damaged spleen area was 5.2?0.1cm2,the maximum diameter of damaged spleen was 5.6?0.2cm,the damaged pancreas length was 6.3?0.2cm,the time for MAP's to lower by half was 8.8?0.5min,the blood loss for depression of MAP by half was 704.7?14.6ml,the time from injury to death in the first 5 pigs was 25.4?1.8min,ISS was 28.0?0.8.The experimental swine model of abdominal multiple organ trauma was reproduced successfully.Conclusions By using the self-made explosion device and electric firecrackers,the abdominal multiple organ trauma model is reproducible,controllable and stable.It can be generally used in the research of war trauma and traffic accident trauma.

Objective To determine the optimal condition for labeling rat bone marrow mesenchymal stem cells(MSCs) with green fluorescent protein(GFP)infection by lentiviral vector so as to establish a subgroup of MSCs which have a high level of GFP expression.Methods MSCs were infected with GFP by lentiviral vector for 12h or 24h at different MOI(25,50,100,200 and 400).The infection efficiency and fluorescence intensity were analyzed by inverted fluorescent microscopy and flow cytometry.The effect of infection at different MOI on proliferation of MSCs was evaluated by MTT.Based on those mentioned above,we could determine the optimal condition for infection.Then single cell clones of MSCs labeled with GFP under optimal condition were selected by using cloning rings.Results The efficiency of infection for 24h at MOI 100,200 and 400 was 88.94%,99.65% and 99.42%,respectively.The infection had no significant effect on the proliferation of MSCs infected at MOI 100 or 200,compared with MSCs without infection.However,those MSCs infected at MOI 400 proliferated slowly.The rate of GFP expression on single-cell clone of MSCs infected for 24h at MOI 200 was 99.95%,and their fluorescence intensity was strong and uniform.Conclusion Infection for 24h at MOI 200 is optimal for labeling rat bone marrow MSCs with GFP by a lentiviral vector.A subgroup of MSCs which have a stably high level of GFP expression can be obtained by single cell cloning technique.

Objective To study the effects of a cirrhotic environment on the metastasis of liver cancer in mice.Methods Male BALB/c mice were randomly assigned to two groups:cirrhosis group and control group.The cirrhosis group was treated by an injection of carbon tetrachloride intraperitoneally.H22 liver cancer cells were directly implanted under the capsule of each group after cirrhosis was established.The animals were sacrificed at 1,2,and 3 weeks after the operation.The metastatic behavior of the cancer cells was observed by the naked eye and microscopically.Additionally,the adhesion ability of the liver was assessed by measuring the expression of vascular cell adhesion molecule 1 (VCAM-1),E-selectin,and E-cadherin.Results After the operation,the cirrhosis group showed an obvious metastatic tendency in both intrahepatic (14/19) and extrahepatic ways (4/19),compared with the control group's intrahepatic (5/17) and extrahepatic ways (1/17) (P＜0.05).Immunohistochemisty for VCAM-1 and E-selectin showed a significant increase in the cirrhosis (P＜0.05).However,there was no difference observed in the E-cadherin between the cirrhosis and control group.Conclusion A cirrhotic liver environment may promote the metastasis of liver cancer cells by increasing the ability of liver adhesion.

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