Objective To analyze the effect of clinical pathway of nursing on health education in patients undergoing tonsil-lectomy.Methods Participants included 180 patients undergoing tonsillectomy in our hospital from September 2012 to September 2013 were randomly divided into the clinical pathway of nursing group ( experimental group) and the traditional nursing group ( control group) with 90 cases in each group.The sleep quality, heart rate, blood pressure, body weight, hemorrhage, health education com-pliance rate and nursing service satisfaction were recorded and compared between the two groups.Results The sleep quality, health education compliance rate and nursing service satisfaction in the experimental group was better than that in the control group;The inci-dence of heart rate speed up, blood pressure increase, loss weight, the standard rate of health education, hemorrhage and the satisfac-tion of nursing quality was lower than that in the control group.There was statistical significance in the difference between the two groups (p<0.05).Conclusion Health education with the clinical pathway of nursing can improve the quality of nursing, promote the rehabilitation and increase the nursing service satisfaction .

[Objective]To study the effect of sixpetal clematis root injection(WLX)on histology,collagen phenotype and ultramicrostructurc in cartilage of osteoarthritis animal model.[Method]OA model animals were randomly divided into 3 groups:group S,group D and group K.Animals in group S received WLX and animals in group D received sterilized normal saline intramuscularly,group K was control and received nothing.After the animals were killed,cartilage specimen were obtained and sections were made and stained with HE/SOFG for Mankin score;the expression level of collagen Ⅰ and Ⅱ in matrix was tested by immunohistochemistry;change of ultramicrostructure of cartilage was observed with transmission electron microscope.[Result]Mankin score in group S was better than that in group D and K at each test period;result of IHC shows that positive stain area of collagen Ⅰ was lower in group S than that in group D and K,and positive stain area of collagen Ⅱ was higher than that in group D and K at each test period;cartilage impairment degree in group S was lower than in group D and K,and impairment manifestation in group D and K was similar on the whole.[Conclusion]sixpetal clematis root injection may protect articular cartilage by maintaining and promoting the chondrocyte synthesizing proteoglycan and type Ⅱ collagen.

Objective To investigate the role of PKCδin free fatty acid-induced endothelial cell apoptosis.Methods In addi-tion,we looked for evidence of apoptosis-related PKCδsignal pathway.Human umbilical vein endothelial cells were treated with va-rious concentrations of free fatty acids and transiently transfected with PKCδsiRNA to inhibit PKCδ expression.Cell proliferation was determined through colorimetric assays,and apoptosis was quantified using flow cytometry.Protein expression was determined from cell lysates use Western blots with antibodies against p-PKCδ Tyr512,PKCδ.Statistical analyses were performed.Results Free fatty acids had multiple effects on human umbilical vein endothelial cells,including concentration-dependent inhibition of cell proliferation,induction of apoptosis,increased Fas expression,and increased PKCδ expression and phosphorylation.Inhibition of PKCδmRNA expression by PKCδsiRNA led to a reduction in free fatty acid-induced apoptosis.Conclusion The free fatty acids-induced apoptosis in endothelial cells are possibly mediated by PKCδ.

Objective To investigate the effects of epinephrine in sepsis-associated lung injury in rats. Methods Thirty SD rats were randomly divided into three groups(n =10 per group):control group received intravenous 0. 9% saline 2. 4 ml/( kg·h ); LPS group received intravenous LPS ( 6 mg/kg ); epi-nephrine treatment group received an infusion of epinephrine 0. 6μg/( kg·min) after LPS intravenous injec-tion . Blood samples were taken at 2 h and 6 h after LPS injection and the levels of serum tumor necrosis factor ( TNF)-α,interleukin( IL)-6 and IL-10 were detected. The rats were sacrificed at 6 h. The lung tissues and bronchoalveolar lavage fluid( BALF) were collected. Pathological changes of the lung tissues were observed under light microscope. Water content of lung,expression of TNF-α,IL-6 and IL-10 in BALF and in serum were detected. Results (1) The water content of lung in LPS group significantly increased compared with that in control group(85. 24% ± 5. 87% vs. 70. 19% ± 5. 87%) and epinephrine group(78. 00% ± 6. 41%) (P<0. 05). (2)Pathological examination showed that LPS could cause pulmonary capillary hyperemia,ede-ma,inflammatory cells infiltration. Atelectasis and alveolar edema were found in small number of lung tissue. Compared with LPS group, epinephrine ameliorated the lung pathological injury. ( 3 ) Compared with LPS group,serum levels of TNF-α and IL-6 significantly decreased ( P <0. 05 ) , whereas IL-10 increased ( P <0. 05) in epinephrine group. (4)Compared with LPS group,BALF levels of TNF-α[(78 ± 9)ng/L vs. (102 ±16)ng/L]andIL-6[(268±42)ng/Lvs.(347±50)ng/L]significantlydepressed(P<0.05),whereas BALFlevelsofIL-10[(210±23)ng/Lvs.(146±34) ng/L]elevated(P <0.05) inepinephrinegroup. Conclusion Epinephrine could reduce the acute lung injury caused by LPS. Its protective effect may be re-lated to decreasing the levels of TNF-α and IL-6,elevating IL-10 level.

BACKGROUND:Hemostatic dressing can directly contact with the body tissues on the wound surface. The biocompatibility is one of the important indicators of evaluating the advantages and disadvantages of dressing. The hemostatic dressing prepared with calcium alginate as raw material has become a research focus owing to its low cost and good compatibility. OBJECTIVE:To observe the cytotoxicity of calcium alginate hemostatic dressings and to compare the cytotoxicity between calcium alginate hemostatic dressing and gelatin hemostatic sponge, absorbing cotton, ordinary gauze. METHEDS:Leaching solution method: the DMEM high glucose culture solution was taken as the leaching medium. The calcium alginate hemostatic dressing, gelatin hemostatic sponge, absorbing cotton and ordinary gauze leaching solution were respectively prepared. Five concentration gradients of 100%, 75%, 50%, 25%, 50% were set. The fibroblast cels of L-929 mouse were cultured for 24 hours with the above material leaching solution. The volume fraction of 10% DMEM high glucose culture medium was taken as control group, and DMEM high glucose culture medium containing 5% DMSO was taken as positive control group to observe the cel proliferation and morphological changes. Direct contact method: The fibroblast cels of L-929 mouse were respectively seeded in calcium alginate hemostatic dressing, gelatin hemostatic sponge, absorbing cotton and ordinary gauze and cultured for 24 hours. The changes in cel morphology were observed.
RESULTS AND CONCLUSION: Leaching solution method: The cytotoxicity of alginate fiber hemostatic dressing, gauze, absorbing cotton leaching solution with different concentration gradients was grade 1, which was in line with GB/T16886/ ISO10993 biological evaluation standard of medical apparatus and instruments. The cytotoxicity of 100%, 75% gelatin hemostatic sponge extract solution was grade 3, causing severe inhibition of cel proliferation. Direct contact method: The cytotoxicity of gauze and alginate fiber hemostatic dressing was grade 1, absorbing cotton was grade 2, gelatin hemostatic sponge was grade 3. These results demonstrate that calcium alginate hemostatic dressing has no cytotoxicity.

Objective To explore the protective role of the receptor tyrosine kinase inhibitor in chondrocyte in vitro.MethodsReverse transcription-polymerase chain reaction (RT-PCR), immunocytochemistry (ICC) and toluidine blue staining were used to understand the changes of phenotype expression of collagenⅠ, Ⅱ and proteoglycan in chondrocyte in vitro. Results Genistein of 20 μg/mL and 25 μg/mL concentrations decreased the expression of collagen Ⅰ and increased the expression of collagen Ⅱ and proteoglycan (P< 0. 05). Conclusions This study showes that genistein can effectively inhibit the expression of collagen Ⅰ above certain concentration, and it can improve the expression of collagen Ⅱ and increase the synthesis of proteoglycan.

Objective To explore the thyroid function changes of episodes period and remissions period in children with primary nephrotic syndrome (NS).Methods The urinary protein quantitation and serum albumin,total cholesterol,thyroid hormone level [total triiodothyronine (TT3),total thyroxine (TT4),free triiodothyronine (FT3),free thyroxine (FT4) and thyroid stimulating hormone (TSH)] of episodes period and remissions period in 15 children with primary NS were retrospectively analyzed.Results There were statistical differences in urinary protein quantitation and serum albumin,total cholesterol in children with NS between episodes period and remissions period (P ＜ 0.05).The TT3,TT4,FT3,FT4 in episodes period were significantly lower than those in remissions period [(0.6 ± 0.3) μ g/L vs.(1.3 ± 0.3) μ g/L,(40.0 ± 23.0)μ g/L vs.(68.0 ± 15.0) μ g/L,(1.6 ± 0.3) pmol/L vs.(3.3 ± 0.3) pmol/L,(8.6 ± 2.5) pmol/L vs.(12.2 ± 2.0) pmol/L],TSH was significantly higher than that in remissions period [(5.6 ± 2.1) mU/L vs.(2.5 ± 1.1) mU/L],there were statistical differences (P ＜ 0.05).Conclusions Thyroid function of episodes period in children with primary NS is decreased temporarily,associated with heavy proteinuria leads to thyroid hormone missing from urine.Detecting thyroid function plays an important role in estimating the state and guiding the treatment of primary NS.

Objective:To investigate the effect of standardized nutritional therapy for gastric cancer during perioperation.Methods:Seventy-six patients with gastric cancer who underwent nutritional therapy were randomly divided into observation group (38 patients) and control group (38 patients),between May 2015 and May 2016.In the observation group,the nutritional therapy was made by medical workers who had received the training of Total Nutritional Therapy (TNT) and Goal Nutrition Therapy (GNT) for Cancer Patient.In the control group,the nutritional therapy was given by doctors according to their conventional experience.Nutritional conditions,gastrointestinal function recovery conditions,complications and hospital stays were compared between the two groups.Results:First,the weight,triceps skinfold thickness and arm muscle circumference of preoperative 1 day and postoperative 7 day in the observation patients were significantly higher than those in the control patients (P ＜ 0.05).Second,the level of serum prealbumin of preoperative 1 day,postoperative 1 and 7 day in the observation patients was significantly higher than that in the control patients (P ＜ 0.05).Third,the time of anus exhaust and defecate in observation group was significantly shorter than that in the control group (P ＜ 0.01).Fourth,each group had one patient who suffered bleeding after operation,and 2 patients in control group had anastomotic leakage.Fifth,the time of hospital stays in the observation group was significantly shorter than that in the control group (P ＜ 0.01).Conclusion:The standardized nutritional therapy for gastric cancer can improve the patient's nutrition status,promote the recovery of gastrointestinal function,and then decrease the time of hospital stays during perioperation.

Aims To study the effects of diterpenoid pekinenal of Euphorbia pekinensis Rupr. on cell prolif-eration, cell cycle phase and apoptosis of hepatoma SMMC-7721 cells and to probe into its anti-cancer mechanisms. Methods MTT assay was used to inves-tigate the effect of pekinenal on proliferation of SMMC-7721 cells; TUNEL method, Annexin V/PI staining and electron microscopy were employed to observe the cell apoptosis; Flow cytometry was applied to analyze the distribution of cell cycle. Results Proliferation of SMMC-7721 cells was markedly inhibited by pekinenal in a dose-dependent manner; Annexin V/PI staining showed that with the increase of pekinenal concentra-tion, apoptotic rate of SMMC-7721 cells increased sig-nificantly, compared with control group, the difference has significant statistical significance ( P < 0. 01 ) . TUNEL method test results showed that different con-centrations of pekinenal in SMMC-7721 cells could in-duce liver cancer cell apoptotic and apoptotic index ( AI) increased significantly ( P <0. 01 ) with the in-crease of drug concentration. Compared with control group, electron microscope found that after the treat-ment, hepatocyte mitochondrial swelling, endoplasmic reticulum expansion, cytoplasm inclusion body forma-tion, part of the nucleus apoptosis, and the more obvi-ous apoptosis appeared with the increase of drug con-centration. Flow cytometry analysis showed that differ-ent concentrations of pekinenal could all make the cell block in S phase. Conclusion Pekinenal has an obvi-ously inhibitory effect on the human liver cancer cells, and there is significant concentration dependence; Pe-kinenal probably inhibits cancer cell DNA synthesis for the human liver cell cycle arrest in S phase and inhibits the proliferation . It plays a role in liver cancer inhibi-tion by inducing liver cancer cells apoptosis, etc.

Objective To study the ability of standard strain and clinical isolates of Ureaplasma spp. to form biofilms in vitro and to compare the antibiotic susceptibility of sessile cells and their planktonic counterparts. Methods A total of 21 Ureaplasma wealyticum(Uu) isolates recovered from female patients diagnosed with cervicitis and Uu serovar 3 and Uu serovar 8( Uu3, Uu8) were included. Scanning electron microscope and confocal scanning laser microscopy were used to identify biofilm formation. Conventional antibiotic susceptibility tests and biofilm susceptibility assays for tetracycline, erythromycin and ciprofloxacin were carried out. The paired rank sum test and was applied to analyze the statistical differences between the MIC and the minimal biofilm inhibitory concentration. The x2 test was applied to analyze the statistical differences of global resistance percentages between planktonic cells and sessile cells. Results Uu3, Uu8 and 21 Uu isolates all can form biofilms in vitro. Minimal inhibitory concentration of sessile cells compared with planktonic cells were obviously higher for tetracycline, erythromycin and ciprofloxacin (P <0.001). Global resistance percentages between planktonic cells and sessile cells were different for erythromycin (9.52% vs 61.90% , P < 0. 001), ciprofloxacin ( 80. 95% vs 100% , P = 0. 035 ) and tetracycline (4. 76% vs 14.29% , P =0.293). Conclusion Uu isolates and Uu1, Uu8 all can form biofilms in vitro, and biofilm formation can strengthen resistance of Uu to antibiotics, even multidrug resistance was observed.