Objective To observe the Influence of improved ICU checklist on instrument management. Methods Reformed and improved the instrument delivery project in ICU checklist. The transfer situation from November 2014 to April 2015 as the control group.The situation from May to October in 2015 as the observation group.Compared the two groups of items of the transfer situation,the condition of nurses′ mastery of instrument parameters,the number of adverse events associated with the instrument and the satisfaction degree of the doctor on nursing work. Results Experimental instrument handover items in succession rate, incidence of adverse events, the doctor to nurse job satisfaction were 25.3% (278/1098), 6 cases, 93% (27/29), the control group were 59.6% (655/1098), 20 cases, 81% (17/21), the difference was statistically significant (χ2 = 264.868, 7.629, 70.046, P < 0.05 or 0.01). Conclusions Improved ICU checklist on instrument management can effectively promote nurses′mastery of instrument parameters, reduce the occurrence of nursing adverse events, ensure patient safety, improve the doctors′ satisfaction on nursing job, and provide an important basis for nursing safety management department.

Objective To explore the characteristics of diagnosis and treatment of thoracoabdominal combined injuries (TCI). Methods A retrospective study was carried out in 92 cases of TCI treated surgically, among whom were 41 cases (44.57%) with penetrating injury caused by sharp instument and 51 (55.43%) with blunt injury. Traffic injury was commonly seen. The injuries due to different causes and their clinical signs as well as operative measures were analyzed. Results Of 92 cases, 42 (45.65%) had diaphragmatic ruptures preoperatively, 88 (95.65%) diaphragmatic rupture was found in the first operation and was repaired; 4 (4.35%) did not receive disgnosis due to neglect of the diaphragm in operation; and 13 (14.13%) died. Conclusions TCI is a special type of multiple trauma with severe and complicated injuries and a high mortality. The diagnosis should be based on the mechanism of trauma and volume of bleeding. In the meantime, special attention should be paid to avoiding the missed diagnosis of diaphragmatic injuries. The treatment principle is thoracic injury first and laparotomy second.

Objective To investigate the efficacy of steroid spray nose treated in child with chronic nasosi- nusitis.Methods 161 cases who were examined a patient of the 5～14 years old child of a chronicⅠtype nasosi- nusitis were divided into two groups,A group 92 cases,spray with the steroid spray nose+the complex treatment.B group 69 cases,only uses the complex treatment,a month of the course of treatment,two groups of all match with the nasal sinuses to douche.Results All cases were followed-up for at least 6 months.In A group,71 cases were cured,13 cases turned for the better,8 was invalid.Total efficient rate was 91.3 %.In 13 group,40 cases were cured, 13 cases turned for the better,16 was invalid.The efficient rate was 76.8 %.The A group obviously surpassed the B group(P

This study was aimed to establish a method for the determination of octylacetate in Jing-Fu-Kang (JFK) granules. The content was determined by GC with Agilent HP-5 (30 m × 0.32 mm × 0.25μm) capillary column, with hydrogen flame ionization (FID) as detector. The injector temperature was 220℃. The detector temperature was 260℃. The split ratio was 20:1. At first, the temperature should be maintained to 80℃for 2 min, and then heating up to 200℃with the speed of 10℃·min-1. This temperature was maintained for 10 min. The results showed that the good linear relationship of octylacetate was within the range of 0.156 5-7.824 2 mg·mL-1, r=0.999 9. The average recovery rate was 100.00%, and RSD was 1.91%(n=9). The lowest detection limit of octylacetate was 1.633 6 ng. It was concluded that the established method was simple and reproducible with no interference. It can be applied to the quality control of JFK granules.

Objective To study the chitin enzyme protein(YKL-40),sCD40L,AFP and the correlation of hypertension with cor-onary heart disease(CHD).Methods 75 cases of elderly patients with CHD were selected as observation group,and then were di-vided into hypertension group and non hypertension group according to the blood pressure.103 cases of healthy elderly were select-ed as control group.ELISA method was used to detect YKL-40 and sCD40L,and AFP was detected by chemiluminescence immuno-assay.Results Clinical data comparison revealed that the relative risk of CHD with hypertension group and non hypertension of hy-perlipidemia,drinking,smoking,diabetes mellitus,were 1.56,1.33,1.23,1.15 times,data show that relative risk of CHD with hy-pertension were much greater than CHD without hyperlipidemia.The concentration of YKL-40 in CHD with hypertension(92.66± 12.04)ng/mL was significant higher than that in CHD without hypertension (57.08 ± 10.07 )ng/mL,and the concentration of sCD40L in CHD with hypertension (186.59 ± 69.63 )ng/mL was significant higher than that in CHD without hypertension (128.14±48.37)ng/mL(P <0.05).There was no significant difference in the concentration of AFP in patients with CHD with hy-pertension and non hypertension(P >0.05).Conclusion The levels of YKL-40,CD40L and AFP in the peripheral blood of elderly patients with CHD were significantly increased.And the concentration of sCD40L and YKL-40 was positively correlated with hy-pertension,which can be used to assess the stability and prognosis of CHD.

Objective To detect the proliferation and the expression levels of downstream target genes of Notch pathway of T-ALL CCRF-CEM(CEM)cell line treated with exogenous DLK1 protein,in order to investigatethe effects of DLK1 protein on the Notch pathway in CEM cells.Methods CCK-8 assay was performed to examine the proliferation of CCRF-CEM cells,which were treated with various concentration(0.5,1.0,1.5 μg/ml)DLK1 for various time(24,48,72 h).RFQ-PCR was applied to assess the mRNA expression level of Notch1 receptor and downstream target genes of Notch pathway in CEM cells,which were treated for various time(24,48,72 h).Results DLK1 protein stimulated the proliferation of CCRF-CEM cells,and the proliferation rates with different concentrations of DLK1 were 0.14±0.03,0.17±0.04,0.55±0.01 in 72 hours,respectively,there were statistic differences between that in the experimental group and that in the control group(P＜0.05).DLK1 protein up-regulated the Notch1 receptor and its downstream target genes HES1,c-myc and NF-κB.The relative transcript levels of target genes HES1 in 72 hours,c-myc in 48 hours and NF-κB in 72 hours were 3.2551±0.3100,1.6086±0.0941,2.0515±0.3453 respectively,and there were statistic differences between that in the experimental group and that in the control group(P＜0.05).Conclusion DLK1 protein stimulates the proliferation of T-ALL CCRF-CEM cells by up-regulating Notch1 receptor and downstream target genes HES1,c-myc and NF-κB of Notch pathway.

Objective To summarize the sonographic characteristics of parathyroid adenomas(PAs) and investigate the diagnostic values and best diagnostic thinking for an early detection. Methods Sixteen cases finally proved with PAs were retrospectively analyzed of their clinical complaints, the department for their initial consultation,indicative ultrasound findings for neck scanning, major manifestations of PAs on a series of three-mode ultrasound imagings,association of adenoma sizes to serum parathyroid hormone(PTH) levels. Results On multimode ultrasound images, the PAs were multidisciplinary morphologic, homogenously hypoeehoic,absent of calculus and necrosis,highly vascularized with color signals,and similar to thyroid in contrast agents perfusion. Serum PTH levels were elevated in accordance with increase of adenomas' size. Among the 16 cases 12 were defined as with parathyroid incidentalomas, to which liver or/ and kidney stones were contributed as indicatives. Conclusions High frequency ultrasound with multiple imaging modes are most suitable for scanning and detection of neck PAs. For those with stones in liver and urinary tracts, unknown bone fracture etc, ultrasound scanning of the neck parathyroids used to reveal latent PAs.

BACKGROUND:Bone marrow is the main source of mesenchymal stem cells(MSCs)at present,but its application has been limited,because of some reasons such as inconvenience of isolation,and the quantity of cells decreases with human increased age.Umbilical cord as a new source of MSCs has been widespread concerned recently.OBJECTIVE:To explore the approach of isolating and culturing MSCs from Wharton's jelly of human umbilical cord,and the methods of identifying the surface antigens and the differentiation potential.METHODS:MSCs were isolated and amplified via tissue-cultivation,and cultured by FasGrow medium.Morphology of MSCs from Wharton's jelly of human umbilical cord was observed under the optical microscope.Its immunophenotypes were detected using immunohistochemistry.The differentiation of MSCs into the osteoblasts was determined utilizing Gomori calcium-cobalt alkaline phosphatase staining,von Kossa calcium node staining,and tetracyclinefluorescence labeling.The differentiation of MSCs into the adipocytes was detected using oil red O staining.RESULTS AND CONCLUSION:MSCs were easily obtained from Wharton's jelly of human umbilical cord via the proposed approach.The primary cells grew up to 70%-80% confluence after 12-16 days of culture,and meanwhile the undifferentiated state was maintained and proliferation was stabilized after passage.The cell cycle of double increase was about 2 days,and proliferation in vitro reached twenty generation above.Surface antigen analysis showed that CD44,CD105,CD133,MHC-I were positively expressed,while CD34,CD45 were negatively expressed.Experiments of differentiation in vitro indicated that the obtained cells were capable of differentiating into fat,osteoblast and nerve-like cells.

Objective To explore the method and effect of checklist tool implemented in the safety management of clinical blood transfusion in intensive care unit. Methods A checklist was specially designed according to the technical standard and check system of clinical blood transfusion. 379 patients prescribed a blood transfusion enrolled in ICU from January to May 2013 were conducted as the control group before the checklist was designed. After the application of checklist during the blood transfusion process, 846 patients prescribed a blood transfusion enrolled in ICU from June to December 2013 were conducted as the experimental group. The incidence of blood transfusion safety related adverse events between the two groups was compared. Results The incidence of adverse events was 1.32% (5 of 379 patients) in the control group, and there was no sign of adverse events occurred in the experimental group. The difference had statistical significance (χ2=11.21, P<0.05). Conclusion The application of checklist reduced the incidence of blood transfusion safety related adverse events,and effectively improved the quality of nursing safety and patient satisfaction.

As a new type of environmental pollutants, microplastics are widely distributed in the global ecosystem, and ingestion of microplastics may produce a number of toxic effects. Based on currently available publications, this paper describes the main pathways of exposure to microplastics, and summarizes the toxic mechanisms of microplastics in mammals, including oxidative stress, inflammatory response, immune damage, imbalance of gut microbiota, energy metabolism disorder and DNA damage, so as to provide insights into elucidation of the toxic mechanism mechanisms and health risk assessment of microplastics.