Objective To discuss the clinical application of medical coordination and hierarchical responsibility system in interventional nursing care which is carried out based on the “Henan Province Model”. Methods From November 2003 to April 2014 at authors’ hospital, medical coordination and hierarchical responsibility system was executed through setting up a ranking system of nursing position , optimizing shift process , dividing physician-nurse medical liability groups , strengthening medical training , implementing medical coordination service mode, etc. The clinical results were compared with those of conventional nursing care that were recorded during the period from May to Oct. of 2013. Results After implementation of medical coordination and hierarchical responsibility system, the quality of medical care, the patent’s satisfaction, the cooperation satisfaction of physicians and nurses were significantly improved. Compared with those before implementation of medical coordination and hierarchical responsibility system , the differences in the above indexes were statistically significant(P<0.01 or P<0.05). Conclusion Based on multidisciplinary joint diagnosis and treatment, and combined with coordination physician-nurse service mode, the enthusiasm of nursing staff can be motivated and the tacit understanding between physicians and nurses as well as the quality of nursing service can be improved. All of the above will promote the development of nursing discipline.

Objective To explore the relationship between homocysteine(HCY),glycosylated hemoglobin(HbA1c),lipids and posterior circulation ischemia and the clinical significance of their levels in the posterior circulation ischemic (PCI)diseases. Methods Difference between PCI were diagnosed in 140 examinees and a healthy control group,with fasting serum,HCY, HbA1c,total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C)and low-density lipoprotein cholesterol (LDL-C)were detected.Results HCY and HbA1c were significantly higher,HDL-C was significantly lower in the patients with PCI,two independent sample t-test showed a significant difference between the test group and control group (P <0.001 and P =0.001),the remaining lipid indicators was not statistically significant.Spearman rank correlation analysis showed that HCY levels had significant positive correlation (P <0.001)and TG levels had significant negative cor-relation (P =0.013)with the subjects age,HCY levels had significant negative correlation with TG levels(P = 0.028), HbA1c levels had significant positive correlation with TG levels and LDL-C levels(P =0.001 and P =0.027).Conclusion High levels of HCY and HbA1c were closely associated with PCI,which HCY and HbA1c should be attached great impor-tance to the effective prevention and treatment and improve of PCI.

Objective To construct HaCaT cell lines stably expressing the wild type human GJB6 gene or its mutant by using a Tet-On lentiviral vector, and to lay an experimental foundation for studies on pathogenesis of hidrotic ectodermal dysplasia. Methods The wild-type human GJB6 gene and its mutant (A88V)were amplified by PCR, and then inserted into the Tet-on lentivirus plasmid to construct recombinant lentivirus vectors. The recombinants were identified by gene sequencing and enzymatic digestion. Cultured HaCaT cells were classified into three groups to be transfected with a negative control lentiviral vector (NC group), the lentivirus vector expressing the wild-type human GJB6 gene (WT group), or the lentivirus vector expressing the mutant human GJB6 gene (MU group). Puromycin was used to select HaCaT cell clones stably expressing the GJB6 gene which encodes the connexin 30 (Cx30)protein. The selected HaCaT cell clones were cultured with or without tetracycline for 48 hours, thereafter, real-time PCR(RT-PCR) was performed to detect GJB6 gene mRNA expression, Western-blot analysis to measure expressions of Cx30 and FLAG-tag proteins, and cell counting kit 8 (CCK8)assay to evaluate cellular proliferative activity. Results Enzymatic digestion and gene sequencing showed that recombinant lentivirus plasmids were successfully constructed. RT-PCR showed evidently increased mRNA expression of the GJB6 gene in stably transfected HaCaT cells. Moreover, the expression abundance of the GJB6 gene was 112.369 times higher in the WT group induced by tetracycline than in that without tetracycline treatment (P < 0.05), and 2.249 times higher in the MU group induced by tetracycline than in that without tetracycline treatment (P < 0.05). Western-blot analysis showed that Cx30 and FLAG-tag proteins were stably expressed in the WT group and MU group after induction with tetracycline, while neither of them was observed in the WT group or MU group without tetracycline treatment, or in the NC group. Significant differences were noted in cellular proliferative activity (expressed as the absorbance value at 450 nm)between the MU group with and without tetracycline treatment and between the WT group with and without tetracycline treatment at 4, 8, 12, 24, 36 and 48 hours (all P <0.05), but not between the NC group with and without tetracycline treatment at any of the above time points (all P >0.05). Conclusion HaCaT cell lines which stably express the wild-type GJB6 gene or its mutant(A88V)are successfully constructed.

Objective:To investigate the clinical characteristics and related factors of patients with chronic obstructive pulmonary disease (COPD) complicated by obstructive sleep apnea (OSA).Methods:The clinical data of 153 patients with COPD who received treatment in Xiangyang First People's Hospital from July 2018 to December 2019 were retrospectively analyzed. A total of 101 patients with complete data regarding pulmonary function and polysomnography who met inclusion criteria were selected. They were divided into simple COPD (COPD group, n = 33) and COPD + OSA (OS group, n = 68) groups according to whether they developed OSA. General clinical data, pulmonary function indexes and polysomnography indexes were compared between the COPD and OS groups. Logistic regression analysis was performed to analyze the degree of airflow limitation and the related factors of COPD combined with OSA. Results:There were more males than females in each group. In the OS group, the proportion of males, body mass index, forced expiratory volume in one second (FEV 1), forced expiratory volume in 1 second percent predicted (FEV 1%pred), the ratio of FEV 1 to forced vital capacity (FVC), apnea-hypopnea index and oxygen desaturation index in the OS group were 92.6%, 24.0 (23.4, 24.8) kg/m 2, 1.2 (1.2, 1.5) L, 50.0 (49.6, 59.4)%, 49.1 (46.9, 53.0)%, 15.4 (16.4, 25.3) times/h, 14.8 (17.3, 25.6) times/h, respectively, which were significantly higher than those in the COPD group [75.8%, 23.0 (21.6, 23.7) kg/m 2, 0.9 (0.9, 1.1) L, 41.0 (38.3, 49.1) %, 41.9 (39.5, 49.24)%, 1.9 (1.6, 2.4) times/h, 4.0 (3.7, 9.7) times/h, t or U = 4.246, 1 399.000, 1 544.500, 1 483.000, 1 407.000, 2 244.000, 1 915.000, all P < 0.05]. The lowest oxygen saturation at night in the OS group was significantly lower than that in the COPD group [81.5 (79.4, 82.6) % vs. 87.0 (80.2, 86.6) %, U = 758.500, P < 0.05]. There were no significant differences in age, smoking index and forced vital capacity between COPD and OS groups ( t = - 0.963, 1 150.000, - 1.954, all P > 0.05). Correlation and Logistic regression analysis revealed that the risk of severe or very severe airflow limitation was lower in the OS group than in the COPD group ( OR = 0.392, P < 0.05). BMI, FEV 1, FEV 1%pred were the risk factors of COPD combined with OSA ( OR = 1.185, 5.554, 1.034, all P < 0.05). BMI and FEV 1 were the independent risk factors of COPD combined with OSA ( OR = 1.168, 5.248, both P < 0.05). Conclusion:COPD and OSA are more common in males and in patients with higher BMI. OSA patients tend to develop lower degree of airflow limitation and more severe hypoxemia and apnea-hypopnea at night than COPD patients. Apnea-hypopnea index is the protective factor against airflow limitation in COPD. BMI, FEV 1 and FEV 1%pred are the risk factors of COPD combined with OSA. BMI and FEV 1 are the independent risk factors of COPD combined with OSA.

An electrochemical sensor incorporating a signal enhancement for the determination of lead (Ⅱ) ions (Pb2+) was designed on the basis of the thrombin-binding aptamer (TBA) as a molecular recognition element and ionic liquid supported cerium oxide (CeO2) nanoparticles-carbon nanotubes composite modification. The composite comprises nanoparticles CeO2, multi-wall carbon nanotubes (MWNTs)and hydrophobic room temperature ionic liquid (RTIL) l-ethyl-3-methylimidazolium tetrafluoroborate (EM1MBF4). The electrochemical sensors were fabricated by immersing the CeO2-MWNTs-EMIMBF4 modified glassy carbon electrode (GCE) into the solution of TBA probe. In the presence of Pb2+, the TBA probe could form stable G-quartet structure by the specific binding interactions between Pb2+ and TBA. The TBA-bound Pb2+ can be electrochemically reduced, which provides a readout signal for quantitative detection of Pb2+. The reduction peak current is linearly related to the concentration of Pb2+ from 1.0 × 10 8 M to 1.0 × 10-5 M with a detection limit of 5 × 109 M. This work demonstrates that the CeO2-MWNTs-EMIMBF4 nanocomposite modified GCE provides a promising platform for immobilizing the TBA probe and enhancing the sensitivity of the DNA-based sensors.

Objective To summarize the methods of diagnosing and treating solid-pseudopapillary neoplasm of pancreas SPN so as to provide reference for its early clinical diagnosis.Methods We collected the clinical data of 62 patients with pathologically confirmed diagnosis of SPN treated in the First Affiliated Hospital of Xi'an Jiaotong University between Feb.2004 and Sep.2014.Then we retroactively analyzed and summarized the clinical characteristics,diagnosis and treatment of the disease.Results Among the 62 patients,55 were female and 7 were male;the mean age was (31.58±12.67) years old.The clinical features showed no specificity and the tumor was mostly detected upon physical check-up.The tumor was seen to be located mostly in the body and tail of the pancreas,and the average maximum diameter was (7.81±3.54)cm.We did not find obvious abnormality in routine pre-operative blood test results or liver and kidney functions.The imageological examination indicated tumor occupation in the pancreas.All the patients underwent surgical resection with no complications or death and had a good recovery after operation.Pathological diagnosis after operation was SPN without metastasis in lymph modes.Until the last time we followed up all the patients,we found relapse in two patients (3.2％).Conclusion SPN is a tumor that tends to affect young and middle-aged females.The malignancy grade of SPN is low,and patients with this disease show no specificity in clinical manifestation.The imageological examination is of vital importance in diagnosing SPN and surgical resection is an effective way to treat SPN.

This study was aimed to investigate the effect of baicalin on the proportion of Th22 cells and the concentration of IL-22 bothin vivo andin vitro, in order to explore the immune mechanism of baicalin on inflammatory bowel disease mice model. The 3.5% dextran sodium sulfate (DSS) was used on C57BL/6 mice for the establishment of colitis mice model. Mice were randomly divided into the blank control group, model group, and baicalin group. Flow cytometry and ELISA were used in the detection of the proportion of Th22 cells and concentration of IL-22 in peripheral blood serum, respectively. The spleen lymphocytes of mice were isolated and cultured by baicalin medium (0, 10, 20, 40μM) for 48 h. Flow cytometry was used in the detection of the proportion of Th22 cells. The results showed that baicalin reduced the proportion of Th22 cells and the expression of IL-22 bothin vivo andin vitro experiments. It was concluded that baicalin can inhibit Th22 cell differentiation and expression of IL-22in vitro and DSS-induced colitis mice. It indicated that baicalin had a good treatment potential in Th22 cell-mediated inflammatory diseases.

ObjectiveToinvestigatethecharacteristicsofsinglelacunarinfarct(SLI)andipsilateral multiple lacunar infarction (MLI), and the differences of risk factors and and pathologies betw een them. Methods The clinical data of al patients w ith cerebral infarction in acute internal carotid artery territory from August 1, 2008 to December 13, 2014 w ere analyzed retrospectively. Lacunar infarctions w ere screened according to the clinical manifestations and imaging findings. The patients w ere divided into a SLI, a unilateral MLI in the same blood supply area (MLI 1) and a unilateral MLI in the different blood supply area (MLI 2) group according to the number and location of the lesions show ed on diffusion w eighted imaging. Multivariate logistic regression analysis w as used to identify potential independent risk factors. Results The incidences of ipsilateral carotid plaque (73.33%vs.48.67%; χ2 =5.801, P=0.016), ipsilateral unstable carotid plaque ( 70.0%vs.42.5%; χ2 =7.192, P= 0.007 ), and ipsilateral carotid stenosis ≥50%(16.67%vs.1.77%; χ2 =8.327, P=0.004) of the MLI 1 group w ere significantly higher than those of the SLI group; the incidence of atrial fibril ation of the MLI 2 group w as significantly higher than that of the SLI group (40.0%vs.0.88%; χ2=15.887, P<0.001); there w ere no significant differences in the remaining risk factors among each group. Multivariate logistic regression analysis showed that atrial fibrilation (odds ratio [OR] 14.452, 95% confidence interval [CI] 1.558-134.011; P=0.019) and ipsilateral carotid stenosis ≥50% (OR 11.483, 95%CI 2.202-59.891; P=0.011) w ere the independent risk factors for MLI. Conclusions MLI may have different risk factors and pathogeneses w ith SLI. Atherosclerotic lesions and embolism are the important pathogeneses of MLI, w hile SLI is not.

BACKGROUND: Intra-articular injection of hormone has been applied in the treatment of arthritis because it can alleviate arthralgia rapidly, which is accompanied commonly by progressive cartilage impairments. It is not clear if supplement of growth factor like insulin effect can play a protective role in articular chondrocytes.OBJECTIVE: To observe the effects of insulin or hydrocortisone alone and the combination on the proliferation of chondrocytes.DESIGN: Grouping comparative study, the effect of one medicine was analyzed by using one-factor analysis of variance, while the combined effect was analyzed with multi-factor analysis of variance.SETTING: Guangdong Institute of Trauma Sugery.MATERIALS: Articular cartilage from the knees of New Zealand white rabbits of 4 - 6 weeks old.METHODS: This study was carried out at Guangzhou Traumatic Research Institute from Feberary 2000 to May 2001. Chondrocytes were isolated from the knee joints of New Zealand white rabbits, digested with hyaluronidase,pancreatin and type Ⅱ collagenase and exposed to insulin, hydrocortisone or the combination of insulin and hydrocortisone of different dosage. They were divided into four groups:Control group ( without adding insulin and hydrocortisone), insulin group (0. 035,0. 35,3.5,35 mg/L subgroups), hydrocortisone group(1,5,10,50,100 mg/L subgroups) and insulin(0. 35 mg/L) combined with hydrocortisone(50 mg/L) group. Their influence on chondrocytes proliferation was observed with methyl thiazolyl tetrazolium(MTT) method.sulin.at the concentration of 0. 035 mg/L( P ＜ 0.01 ), reaching the maximum at could inhibit the proliferation of chondrocytes ( P ＜ 0.05 ), which became significant with increasing concentration and no viable chondrocytes could be exposed to 0 . 35 mg/L insulin combined with 50 mg/L hydrocortisone, the promoting effect of insulin was inhibited due to negative cooperation.CONCLUSION: Insulin at low concentration could enhance the proliferation of chondrocytes, but hydrocortisone displayed inhibiting effect on the growth of chondrocytes. The function of insulin was antagonized when combined with hydrocortisone.

BACKGROUND: Dental porcelain crown containing Ni-Cr alloy has been widely used in modern dentistry. The dispute of its safety is limited in oral cavity and neighbor tissues, however, the relevance between Ni-Cr alloy and systemic disease, such as nephridium toxicosis, are poorly understood. OBJECTIVE: To analyze the possibility of Ni-Cr porcelain crown resulted nephropathy and to explore its long-term clinical safety.METHODS: Databases of VIP, CNKI, Wanfang, CBMdisc, Biosis Previews and BioOne were researched by computer with key words of "nickle chromium alloy, porcelain crown, nephridium toxicosis" both in Chinese and English. Literatures concerning Ni-Cr porcelain crown and toxicity of related metal ion were included, repetitive research was excluded. RESULTS AND CONCLUSION: By consulting literatures, the possibility of erosion and release of heavy metal ion lead to nephridium toxicosis were analyzed with following aspects: effects of Ni-Cr alloy corrosivity and its accumulation on oral cavity or systemic disease; direct toxicity of released metal ions from Ni-Cr alloy and susceptivity of nephridium toxicosis; and the possible ways for renal damage resulted by Ni-Cr ion. This study can provide a basis for the further research concerning security of dental porcelain crown containing Ni-Cr alloy.