Behavior Science pays more attention to humanity,and regards the management of people as the key factor of management.Nursing management is the process targeting at the progress of nursing quality and work efficiency.Under the new circumstance,it is very important for the head nurse to supervise the nurses with a scientific management conception in the hospital howadays which will encourage the nurses to fully exert their abilities. and help to improve the nursing quality finally.

OBJECTIVE:To prepare m-nisoldipine solid dispersion from poorly-soluble m-nisoldipine so as to improve its solubility and dissolution rate in vitro. METHODS: Solid dispersions of m-nisoldipine were prepared by coprecipitation method with poloxamer as carrier; Differential scanning calorimetry (DSC) was used to determine the status of nimodipine in carrier. The solubility and the dissolution rate of the solid dispersion in vitro were studied. RESULTS: DSC analysis indicated that eutectic mixture was formed from m-nisoldipine and poloxamer. The solubility of m-nisoldipine and the its solid dispersions prepared from m-nisoldipine and poloxamer at different ratio (1∶3, 1∶5, 1∶7) were 0.89, 4.50, 15.35, and 23.03 mg?L-1, respectively, and their 120 min dissolution rates were 26.80%, 38.57%, 41.38%, and 45.92%, respectively. In the same ratio, the dissolution rates of the solid dispersions were higher than those of their physics mixtures. CONCLUSIONS: The solid dispersion of m-nisoldipine prepared with poloxamer as carrier can increase the solubility and dissolution rate in vitro.

Objective To investigate the therapeutic effect of early stage minimally invasive laparoscopic retroperitoneal approach of catheter drainage on early inflammatory response of severe acute pancreatitis ( SAP ) . Methods 37 SAP patients with peritoneal effusion were divided into the observation group (19 cases with early laparoscopic retroperitoneal approach of catheter drainage )and normal treatment group(18 cases with conventional drainage)using a random number table.All patients were given conventional therapy , such as fasting, gastroin-testinal decompression , anti-infection, fluid resuitation and using gastric acid and trypsin inhibitors .In addition to conventional therapy , the observation group received the early laparoscopic retroperitoneal approach of catheter drainage.The inflammatory indexes responding to acute inflammation such as TNF-α,IL-6,IL-8, IL-10 and C-re-active protein(CRP)were detected before and after treatment .Meanwhile, the date of resume diet, APACHEⅡscores and duration of systemic inflammatory response ( SIRS) , incidence of multiple organ dysfunction syndrome ( MODS) and the mortality were observed .Results The acute inflammatory response occurred in both groups . The plasma levels of TNF-a,IL-6,IL-8,IL-10 and CRP in the two groups decreased obviously after 3-day treat-ment.However, the plasma levels of inflammatory mediators in the normal treatment group increased while those early laparoscopic retroperitoneal approach of catheter drainage group kept decreasing after 7-day treatment .There was a significant difference between the two groups (P<0.01).Time for resuming to diets and duration of SIRS in the observation group were less than those in the normal treatment group ( P<0.01 ) , APACHEⅡscore were significantly less than those in normal treatment group also (P<0.01).The rates of MODS, overall postoperative complication rate and mortality were significantly lower in the observation group (P<0.05).Conclusions Early laparoscopic retroperitoneal approach of catheter drainage can effectively improve the prognosis in patients with SAP and decrease the production of inflammatory mediators .Early laparoscopic retroperitoneal approach of cathe-ter drainage is simple , feasible and micro-invasive with encouraging outcomes , therefore it is an effective and safe treatment option for patients with SAP .

Objective To investigate the feasibility and clinical value of the road drainage after early mini-mally invasive treatment of severe acute pancreatitis (severe acute pancreatitis,SAP).Methods A retrospective analysis were used to investigate the clinical data of 37 patients with SAP in March 2011 to March 2011 after conven-tional treatment and early minimally invasive approach drainage treatment.Drainage of early after minimally invasive approach group were treated by laparoscopic retroperitoneal approach surgery in the early onset,and were removed of necrotic tissue and catheter drainage of the retroperitoneal clearance.Then postoperative double pipe for irrigation and the negative pressure drainage were applied.Two groups of postoperative complications,mortality,medical expenses, length of hospital stay,etc.were compared.Results Early minimally invasive drainage of into the road after acute physiology and chronic health evaluation (APACHE Ⅱ)was superior to the conventional treatment group (P =0.00).The overall incidence of complications and mortality of multiple organ dysfunction syndrome (multiple out-raged dysfunction syndrome,MODS),was superior to the conventional treatment group,and the differences were statis-tically significant (P =0.023,P =0.033,P =0.046).Early into the road drainage of hospitalization expenses after minimally invasive were reduced ((19.74 ±2.22)than (36.15 ±1.92)ten thousand yuan,t =23.989,P =0.000),hospitalization time were shorter (4.76 ±0.64)weeks than (6.03 ±0.73)weeks,t =5.635,P =0.000). Conclusion Early minimally invasive retroperitoneal approach of drainage treatment of SAP can reduce the incidence of complications and mortality,reduce hospitalization expenses,shorten hospitalization time,and has the clinical feasi-bility and application value.

Objective To optimize and establish ELISpot assay for CCP/AST which could secrete IFN-γ and IL-4, and explore the role and clinical significance of CCP/AST cells in occurrence and development of RA disease. Methods CCP was used as specific-stimulator with FLAG peptide as a control,the frequencies of positive SFC which could specifically secrete IFN-γ and IL-4 in 64 cases of RA, 64 cases of non-RA autoinunune diseases and 30 cases of healthy individuals were tested by ELISpot technique. The diagnostic value of CCP/AST cells was evaluated in patients with RA disease. Meanwhile, the relationships among the indexes above and patient joint symptoms as well as other laboratory parameters were further analyzed and discussed. Results The results showed that the mediam numbers of IFN-γ-SFC and IL-4-SFC were 39(12-77)/3 x 105 PBMC and 1 (1-3)/3 × 105 PBMC in RA patients, the positive rates were 81.3% and 18. 8% respectively. The median value of IFN-γ-SFC/IL-4-SFC ratio was of 15(5-39), the positive rate was of 78. 1%. Both IFN-γ-SFC and ratio of IFN-γ-SFC/IL-4-SFC were significantly higher than those of non-RA diseases (Z = - 7. 458, - 7. 019, P < 0. 01 ) and healthy control ( Z = - 6. 643, - 5. 760, P <0. 01 ), also both these parameters in RA patients with positive anti-CCP antibody and negative anti-CCP antibody were significantly higher than those patients with systemic lupus erythematosns ( Z = - 6. 573, - 6. 098, - 4. 552, - 4. 726, P < 0. 01 ), ankylosing spondylitis ( Z = - 3. 520, - 3. 326, - 2. 950,-2. 126, P<0. 01 or 0. 05), other autoimmune diseases (Z = -4. 838, -4. 418, - 3. 681, -3. 839,P < 0. 01 ) and healthy controls ( Z = - 6. 553, - 5. 578, - 4. 635, - 4. 163, P < 0. 01 ). Combining IFN-γ-SFC, IL-4-SFC with IFN-γ-SFC/IL-4-SFC for RA diagnosis, the area under curve of receiver operating characteristic( ROCAUC) and Youden index were 0. 910 and 0. 747. The diagnostic sensitivity and specificity were 87. 5% and 87.2%. Positive and negative predictive values were 82. 4% and 91.1%, respectively. Correlation analysis showed that ratio of IFN-γ-SFC/IL-4-SFC was not only significantly correlated with antiCCP antibody(r =0.393, P <0.01), but also correlated with joint symptoms in patients such as with number of joints swelling-pain ( r = 0. 429 , P < 0. 01 ), number of joints damage ( r = 0. 463, P < 0. 01 ),rheumatoid factor (r = 0. 166, P < 0.01) and erythrocyte sedimentation rate (r=0. 199,P<0.05).Conclusions There is widely existence of CCP/AST cells activation and abnormity in RA patients,indicating higher frequency of CCP-specific Th1 cells. These results provides a new experimental evidence for an objective understanding the function of specific cellular immune responses and cytokine network regulation mediated by citrullinated proteins in RA. So, the assay for CCP/AST cells has potential values in RA diagnosis and clinical application.

BACKGROUND:Tumor stem cels are the root of cancer recurrence and metastasis, so clinical researches should focus on the effects of different treatments on tumor stem cels.
OBJECTIVE:To explore the effects of endocrine therapy and chemotherapy on stem cels in patients with breast cancer.
METHODS:After recovery and cultivation of estrogen receptor-positive human breast cancer cel lines MCF-7, passage 3 cels in logarithmic phase were selected and divided into three groups containing control, estradiol and estradiol with tamoxifen groups. The estradiol group was divided into three subgroups: 10-7, 10-8 and 10-9 mol/L estradiol was added into the medium, respectively; the estradiol with tamoxifen group was divided into three subgroups: 10-7, 10-8 and 10-9 mol/L estradiol with 10-6 mol/L tamoxifen were added into the medium, respectively. The same amount of absolute ethyl ethanol was added into the medium of control group. Fifteen female patients with late recurrence and metastasis of breast cancer received chemotherapy as recurrence and metastasis group. Another 15 healthy volunteers were selected as healthy control group.
RESULTS AND CONCLUSION:The proportion of CD44+CD24-/lowcel subsets in the estradiol and estradiol with tamoxifen groups was significantly higher than that of the control group (P < 0.05), and the proportion of CD44+CD24-/low cel subsets in the estradiol group was significantly higher than that of the estradiol with tamoxifen group at the same concentration (P< 0.05). The proportion of CD44+CD24-/lowcel subsets had no significant differences among groups at 10 and 20 days of culture (P < 0.05). The proportion of CD44+CD24-/low cel subsets significantly increased in MCF-7 cels after 24-hour intervention with different chemotherapy drugs. But only the proportion of CD44+CD24-/low cel subsets in the paclitaxel and doxorubicin groups was significantly higher than that of the control group after 20-day intervention (P < 0.05). Besides, the proportion of CD44+CD24-/low cel subsets in the peripheral blood of healthy volunteers was significantly lower than that of the recurrence and metastasis group (P < 0.05). Among 15 patients with late recurrence and metastatic of breast cancer, 9 had stable disease, 5 had partial remission, 1 had failed chemotherapy and cancer progression. Moreover, the proportion of CD45-CD44+CD24-/low cel subsets in the peripheral blood of patients sensitive for chemotherapy was significantly lower than that before treatment (P < 0.05). In conclusion, both endocrine therapy and chemotherapy exert a certain effect on the CD44+CD24-/low cel subsets of breast cancer positive for estrogen receptor. Given that CD44+CD24-/low cel subsets in MCF-7 cels resist chemotherapy drugs, the proportion of CD45-CD44+CD24-/low cels in the peripheral blood of patients sensitive for chemotherapy is decreased.

Objective To examine the proliferative effect of synthetic cyclic human cartilage glycoprotein-39 (HCgp39) on T cell of collagen-induced arthritis (CIA) rat,and to explore the role of HCgp39 in rheumatoid arthritis (RA).Methods We established the rat model of the collagen-induced arthritis (CIA).The T lymphocytes were isolated and incubated with HCgp39.Proliferation of T cells was determined by cell counting kit-8.Results Two weeks after the first immunization,T cell response to HCgp39 was more significant in CIA groups than in controls( P＜0.01 ),and the response was associated with disease course ( r =0.732,P＜0.01 ) and anti- HCgp39 antibody ( r =0.460,P＜0.01 ).A strong correlation between T cell proliferation and pannus ( r =-0.516,P＜0.01 ),synovium score ( r =-0.346,P＜0.01 ) was also observed.Besides,the levels of anti- HCgp39 antibody and comp in each CIA group were significantly higher than in controls( P＜0.01 ),and the anti- HCgp39 antibody strongly correlated with disease course( r=0.346,P＜0.01 ) and comp( r =0.235,P＜0.01 ).Conclusion The proliferative response of T cell to HCgp39 was found in the early stage of CIA rat,and the HCgp39 peptide antibody was detected in serum,suggesting that the HCgp39 antigen plays an important role in the pathogenesis of early RA.

ObjectiveTo examine the proliferative effect of synthetic C Ⅱ260-272 peptide on T cells of collagen-induced arthritis(CIA) rat,and to explore the role of C Ⅱ 260-272 in RA.MethodsThe rat model of collagen-induced arthritis(CIA) was established.The T lymphocytes were isolated and incubated with C Ⅱ 260-272 peptide.Proliferation of T cells was determined by cell counting kit-8.The data were analyzed with SPSS 17.0.The Mann-Whitney U test was used for proliferation levels comparison between the two groups,and the relationship of cell proliferation with other indicators was analyzed with Spearman's correlation.Antibody levels between the two groups were compared using t test.ResultsThree weeks after the first immunization,T cell response to C Ⅱ 260-272 in the CIA groups [0.963 (0.332-1.628)] was more significant than in controls[0.332 (0.331-0.357)](P＜0.05),and the response was associated with disease course(r=0.624,P＜0.01 ).Strong correlation between T cell proliferation and the antibodies,including antibC Ⅱ antibody and anti-Cit-bC Ⅱ antibody was also observed(P＜0.01 ).Two weeks later,the levels of anti-C Ⅱ peptide antibody in each CIA group were significantly higher than those in the controls(P＜0.01).The antibodies strongly correlated with pannus formation (P＜0.01,P＜0.05).ConclusionThe proliferative response of T cell to C Ⅱ 260-272 peptide can be found in the early stage of CIA rat,and the anti-C Ⅱ peptide antibody could be detected in the serum,which suggeststhat the C Ⅱ peptide may play an important role in activating T/B lymphocytes and causing immune reaction when CIA is induced by C Ⅱ.

Objective To study the tumor targeting ability and application of farnesylthiosalicylic Acid (FTS) and heptamethine carbocyanine fluorescent dye-mediated near-infrared imagine in living animals, and confirm the inhibitory effect of this compound on growth of tumor cells.Methods Human breast cancer cell line MCF-7, glioma cell line U251 and prostate cancer cell line PC3 were cultured to logarithmic growth phase, and different concentrations of FTS and FTS-IR783 were added, respectively.We observed the inhibitory effect of those two compounds on the growth of tumor cells.Under fluorescence microscopy, specific accumulation of FTS-IR783 in these tumor cells was observed.The tumor cells (1×106) were transplanted subcutaneously into nude mice.These mice were subjected to intraperitoneal injection of FTS-IR783 (10 nmol/mouse) two weeks later.In the in vivo imaging, near infrared fluorescence signal and tumor volume were measured and their correlation was analyzed.Results Compared with FTS, FTS-IR783 significantly inhibited the growth of MCF-7, U251 and PC3 cells in vitro.FTS-IR783 was specifically uptaken by these three kinds of tumor cells, showing strong near infrared fluorescence in cell agglomerates.After subcutaneous injection of FTS-IR783, the correlation between fluorescence intensity and tumor volume was 0.987, 0.998 and 0.971, respectively.Conclusions The compound of FTS conjugated with near infrared fluorescent dye IR-783 can specifically recognize tumor cells, in both in vitro and in vivo imaging.At the same time, the compound can significantly inhibit the growth of tumor cells, and may be expected to become a new potential targeted drug.

This paper deeply studied the definition and characteristics of clinical research programs. On such basis, the researchers utilized theoretical and comparative studies in combination of practical studies, to probe deeply into both the operating procedures and management documents of the clinical research management council.These efforts contributed to constructing a systematic, overall and feasible management system,for reference of building such a council by medical institutions.