ObjectiveTo evaluate the effect of psychological intervention on satisfaction degree of patients with severe chest trauma. Methods90 patients with severe chest trauma were randomly divid-ed into the observation group and the control group with 45 cases in each, the control group was treated with conventional care, the observation group received conventional care combined with psychological intervention. The satisfaction degree was compared between the two groups after treatment and interven-tion. ResultsThe total satisfaction degree of the observation group was 71.11%, which was significantly higher than that of the control group, 46.67%. ConclusionsApplication of psychological intervention in treatment of patients with severe chest trauma is effective to improve their satisfaction degree, which should be applied in clinic.

Objective To explore the treatment effect and application value of proximal humeral locking plate combined with injectable bone graft in the treatment of proximal humeral fractures.Methods 86 patients with proximal humeral fractures were selected,using the random number table method they were randomly divided into the observation group and control group,each group had 43 cases.The control group was treated with locking plate method,and the observation group was treated by the combination of artificial bone and locking plate.The therapeutic effect of the two groups was observed.Results The excellent and good rate of the observation group was 93.03％,that of the control group was 74.42％,the difference was statistically significant between the two groups(x2 =5.460 3,P ＜0.05).In observation group,the fracture healing time was (11.78 ± 3.64) weeks,the shoulder joint function score was (96.87 ± 4.23) ; those of the control group were (19.65 ± 6.27) weeks,(78.73 ± 8.28),the differences were statistically significant between the two groups (t =7.118 2,12.793 4,all P ＜ 0.05).The incidence rate of complications of the observation group was 6.98％,which was significantly lower than 30.23％ of the control group (x2 =7.678 6,P ＜ 0.05).Conclusion Proximal humeral locking plate combined with injectable bone graft in the treatment of proximal humeral fracture has reliable curative effect,short fracture healing time and mild surgical complications,which is worth popularizing in clinical.

ObjectiveTo prospectively study the safety and feasibility of sedation with propofol plus fentanyl for cirrhotic patients undergoing upper gastrointestinal endoscopy (UGIE).MethodsA total of 50cirrhotic patients and 50 control subjects without liver diseases referred to UGIE were assigned to the cirrhotic sedation group and the non-cirrhotic sedation group,respectively.Patients of both groups received sedation with propofol plus fentanyl.Meanwhile,30 cirrhotic patients underwent conventional UGIE.Vital signs of all subjects were recorded before sedation and procedure,five minutes,ten minutes and one hour after the procedure.Number connection test A (NCT-A) and line tracing test (LTT) were completed for all patients before sedation or procedures and 4 hours after endoscopy procedures.Occurrence of sedation-related complications was measured.ResultsIn the cirrhotic sedation group and the non-cirrhotic sedation group,blood pressure,heart rate,respiratory rate and saturation of pulse oximetry decreased of different degrees after secation (P ＞ 0.05 or P＜ 0.05),but returned to normal one hour after endoscopy procedures ( P ＞ 0.05).The total complication rates differed significantly between the cirrhotic sedation group and the non-cirrhotic sedation group [ 36％ (18/50) v.s.14％ (7/50),P ＜0.05 ].However,the rate of such complications as hypotension,bradycardia and hypoxemia in both groups was of no statistical difference (P ＞0.05 ).No cirrhotic patient developed overt hepatic encephalopathy after procedures.In addition,the NCT-A and LTT times before and after sedation in the cirrhotic sedation group and the cirrhotic non-sedation group were longer than those before and after procedure in the non-cirrhotic sedation group ( before sedation or procedure:(55.1 ±22.1)s,(58.6±23.1)s v.s.(36.9±7.0)s,(98.6±33.1)s,(89.5±15.6)s v.s.(81.4±13.6)s,P＜0.05; four hours after procedure:(54.4 ±21.6)s,(58.3 ±22.4)s v.s.(36.3 ±6.3)s,(88.4 ±30.6)s,(80.2 ±15.9)s v.s.(71.8 ± 12.0)s,P＜0.05,while there was no difference between cirrhotic sedation group and cirrhotic non-sedation group ( P ＞ 0.05 ).Within-group comparison showed NCT-A did not change ( P ＞ 0.05 ),whereas,LTT was obviously shorter than pre-sedation or pre-procedure ( P ＜ 0.05) due to learning effect.The differences in the NCT-A and LTT times before and after sedation or procedure were not significant among the three groups (P ＞ 0.05 ).ConclusionSedation with propofol plus fentanyl is relatively safe in cirrhotic patients during UGIE,which will not precipitate hepatic encephalopathy or cause irreversible complications.

Objective To analyze the clinical characteristics of children tsutsugamushi infection in order to strengthen understanding,reduce the misdiagnosis rate,reduce the complications and improve the level of diagnosis and treatment.Methods To analyze retrospectively the clinical data and treatment outcome of 22 cases of children tsutsugamushi disease,including symptoms,physical signs and laboratory examination.Results All the cases with fever onset,high fever (＞ 39 ℃) was 72.7％ (16/22),all cases were typical eschars and ulcers,while 8 cases (36.4％,8/22)had lymphadenectasis.Merger multiple organ damage in 14 cases (63.6％,14/22),anemia in 11 cases (50.0％,11/22)and liver function abnormal in 4 cases (18.2％,4/22).All of 22 cases were treated with azithromycin.All cases after treatment with azithromycin heal,no recurrence.Conclusions The manifestation of tsutsugamushi disease is diversity,much complications,among which hematology and liver are the most common cases.Physical examination roundly might reduce missed diagnosis and misdiagnosis as greatly as possible.Azithromycin has good therapeutic effects on children tsutsgamushi disease.

Education reform and innovative education are the strong requirements of the times and social development.We developed immunological paper free examination system based on the optimized question bank,characteristics of immunological examination and information technology.This system can randomly develop electronic examination paper and can integrate the processes of exam registration,examination paper development,online examination,paper inspection,scores generation and printing into one system,which can save human resources,enhance the accuracy and fairness of the examination,making it conform to international standards.

ObjectiveTo explore the relationship between fat content of postmenopausal osteoporosis patients and bone mineral density (BMD).Methods144 female osteoporotic patients with the age of 50～75 years were choosen from guangdong province from October 2010 to January 2011.According to TCM syndrome differentiations,these patients were divided into kidney Yang deficiency group,liver-kidney Yin deficiency group,spleen and kidney Yang deficiency group and Qi stagnancy and blood stasis group.Four groups of patients were performed total body fat content detection.The data were analyzed by software SPSS 16.0.ResultsComparing of L1～4 average BMD in four groups showed:BMD of Kidney Yang deficiency group was maximum,followed by spleen and kidney Yang deficiency group,and the BMD of Qi stagnancy and blood stasis group was minimum.Comparison between the four groups showed statistical significance (P＜0.05).Comparing of body fat content Iin the four groups showed:the body fat content in the kidney Yang deficiency group was minimum,followed by spleen and kidney Yang deficiency group,and body fat content in Qi stagnancy and blood stasis group was maximum.Pair-comparison in kidney Yang deficiency group,liver-kidney Yin deficiency group,spleen and kidney Yang deficiency group showed no statistical significance (P＞0.05).While these three groups showed statistical difference when comparing with Qi stagnancy and blood stasis group (P＜0.05).The body fat content and L1～4 average BMD had negative correlation.ConclusionOsteoporosis in Qi stagnancy and blood stasis group was more serious than the other three other groups.Fat content was negatively related with bone density.

Objective To observe the effects of 5-fluorouraeil(5-FU)and eisplatin(DDP)on the expression of Toll-like receptor 2 (TLR2)and Toll-like receptor4(TLR4)in hepatocellular carcinoma cell lines HepG2 and HepG2.2.15.Methods Direct immanotlaorescenee flow cytometry was used to detect mean flubrescence intensity(MFI)of TLR2 and TLR4,and TLR2 and TLR4 positive cell percentage in HepG2 and HepG2.2.15 cells before and after treated with 5-FU.and DDP at various concentrations for 24h,48h and 72h.Results MFI of TLR2 and TLR4.and TLR2 and 11LR4 positive cell percentage in HepG2.2.15 cells were significantly higher than those in HepG2(P＜0.01).After HepG2 and HepG2.2.15 cells were treated with different concentration of 5-FU and DDP,MFI of TLR2 and TLR4,TLR2 and TLR4 positive cell percentage in HepG2 and HepG2.2.15 cells almost had no change.only MFI of TLR2 in HepG2.2.15 cells decreased after cells were treated with 5-FU at the concentrations of 100,200μg/ml and DDP at the concentrations of 20μg/ml for 72h(P＜0.05 for all).Conclusions 5-FU and DDP can not activate TLR2 and TLR4 signal pathway in hepatocellular carcinoma cell lines HepG2 and HepG2.2.15.To find the activated pathway in TLR2 and TLR4 signal pathway,some other methods should be used,and this will be helpful in antieancer therapy.

Objective To study the effect of matrine on the expression of a proliferation-inducing ligand (APRIL) in colorectal cancer cell line (SW480 cell). Methods MTT assay was used to evaluate the inhibitory effect of matrine on SW480 cells. The protein and mRNA levels of APRIL in SW480 cells were determined by immunohistochemistry and real-time fluorescence quantitative PCR (RFQ-PCR). SW480 cells were treated with 0.5,1.0,2.0 mg/ml of matrine for 24 h, 48 h and 72 h. FU and blank were served as drug control and blank control groups, respectively. Results Matrine had obviously inhibitory effect on proliferation of SW480 cells in a time- and dose-dependant manner. The expression of APRIL was strong in SW480 cells. When treated with 50,100,200 ug/ml of FU, the APRIL mRNA levels in SW480 cells raised gradually and reached the highest levels at 72 h after treatment, which were significantly higher than those in blank control group (all P value<0.001). When treated with 0. 5,1.0, 2.0 mg/ml of matrine, the APRIL mRNA levels in SW480 cells increased at 24 h after treatment, which were significantly higher than those in blank control group (all P value<0. 001), and then decreased gradually and almost equal to level of blank control group at 72 h. Conclusion In treatment with FU, the survival cells.may have stronger ability of proliferation due to higher expression of APRIL in SW480 cells. Anti-APRIL therapy might be an important assistant treatment to counter the impact of APRIL. Matrine will not cause persistent increase of APRIL mRNA levels in SW480 cells, so it might be a helpful drug in anti-tumor theraphy.

Objective To understand and analyze the situation of orthopedic nursing manpower resources in grade- Ⅲ general hospital in Shanghai and provide empirical evidence for appropriate allocation and exploitation of nursing manpower resources. Methods Data were collected by questionnaire and then underwent analysis. Results In 2009,the number of authorized beds was 1866,the actual number of open beds was 2007.The number of nurses was 595 (2 male).The ratio of ward bed and nurse were 1:0.319 and 1:0.296, calculated by the authorized beds and authorized beds, respectively.The average age of head nurses was (37.53±6.11 ) years old, average working life span was (17.87 ± 6.16) years; college degree or above accounted for 95.56%; middle professional titles accounted for 62.22%. College degree or above accounted for 75.13% in nurses, junior professional titles accounted for 92.1%; age group is mostly concentrated in the 20 to 29 years of age, accounted for 67.06%; working life span concentrated within 10 years, accounted foi 73.11%. The education level mainly is primary school in the care workers (carer), accounted for 45.83%; concentrated in the 40 to 49 years of age, accounted for 60.42%; working life span concentrated in more than 6 years, accounted for 55.21%. Conclusions There are shortage of orthopedic nursing manpower resources, unreasonable allocated structure, lack of male nurses in grade- Ⅲ general hospital in Shanghai. The management of the care workers should be standardized.

Objective:The effect of naltrexone on function of murine peritoneal macrophage in vitro was studied in order to illuminate its immune activity futher. Methods:Peritoneal macrophages were divided in three groups:RPMI1640 blank control group, LPS positive control group and NTX treated group. Various phenotypic and functional indices were tested by MTS, flow cytometry technology,phagocytosis experiment and ELISA. Results: Compared with RPMI1640 group,at a LDN exhibits paradoxical properties;the expression of CD64 on surface increased while the expression of CD206 decreased in NTX group;the expression of tumour necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)were increased. Conclusion:The results of experiment had proved that LDN could influence macrophage polarzation, regulate the inflamatory mediators production and affect the phagocytosis function of peritoneal macrophage.