Objective To investigate the changes of venous cord blood nitric oxide(NO) and endotnelin-1(ET-1) levels and to find out its relationship with umbilical arteries blood flow velocities in the pregnant women with diabetes mellitus.Methods 66 cases of the pregnant women with diabetes mellitus(DM) were selected at random,including 30 diabetes mellitus complicated with pregnancies(DMP) and 36 gestational diabetes mellitus(GDM).36 cases of the normal pregnant(NP) women were selected as the control group.Venous cord blood samples were collected from all the subjects after delivery.Cord blood NO and ET-1 levels were detected by Griess assay and radioimmuno-assay respectively,and umbilical arteries blood flow velocities(S/D) were measured just before delivery.Results Compared with the control group,cord blood NO levels decreased and ET-1 levels increased and S/D increased in the DMP group significantly(P0.05).Conclusion Umbilical blood NO and ET-1 levels are abnormal in DMP,which induces the high resistance of fetal-placental circulation,and finally might cause adverse pregnancy outcomes.

Objective By reviewing the relevant literature, we explored the current status and problems of the evaluation of the training effectiveness, and put forward the corresponding countermeasures, in order to provide a theoretical basis for the effect evaluation of nurse training in China. Methods By searching Citation online search and integration system (CITE), the Chinese biomedical literature service system (CBM), we included the literatures on the effect evaluation of the nurses training in the core journals from January 2006 to November 2015. Retrieval literatures were imported the bibliographic management software Note express by database. The corresponding field were analyzed in the literature′s age distribution, evaluation object, evaluation model, evaluation method, evaluation index and evaluation tool, et al. Results There were 343 literatures had retrieved, the total number of literatures presented a increasing tendency. The evaluation methods, evaluation tools and evaluation indicators presented a tendency of diversity, and the evaluation model was relatively single. Only 16 (4.7%) literatures tried to construct the training effect evaluation system of nurses, which was not based on some theory or hypothesis, which had not been effectively put into practice. Conclusion The effect evaluation system of nurse training needed to be done in depth, such as reconstruction of the new training evaluation model, the establishment of training evaluation system of different professional, different levels, different positions, to research evaluation methods, evaluation criteria and clinical practice testing, to design, training evaluation management software etc.

Objective To evaluate clinical significance of ischemia grade to predict severe arrhythmia in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 225 patients with STEMI admitting to emergency department were enrolled.All enrolled patients were divided into two groups based on the QRS complex electrocardiogram on admission:grade 1Ⅱ ischemia group(135 cases) and grade Ⅲ ischemia group (90 cases).All patients received thrombolytic therapy.The incidence rate of ST segment resolution (STR) and severe arrhythmia in hospital stay was observed.Results The ST segment elevation (Σ.ST) on admission and 2 h after thrombolysis in grade Ⅲ ischemia group was significantly higher than that in grade Ⅱ ischemia group [(0.84 ± 0.57) mV vs.(0.44 ± 0.35) mV,(0.50 ± 0.23) mV vs.(0.11 ± 0.06) mV] (P ＜ 0.01).The backing rate of ST segment ≥ 50％ 2 h after thrombolysis in grade Ⅲ ischemia group was significantly lower than that in grade Ⅱ ischemia group [56.7％ (51/90) vs.83.7％ (113/135)] (P ＜0.01).The creatine kinase MB (CK-MB) peak value in grade Ⅲ ischemia group was significantly higher than that in grade Ⅱ ischemia group [(363 ± 105) U/L vs.(212 ± 97) U/L] (P ＜ 0.01).There was no significant difference in the incidence of severe arrhythmia between two groups (P ＞ 0.05).Multiple Logistic regression analysis demonstrated that the independent predictors of severe arrhythmia were duration from symptom to thrombolysis and initial ΣST,whereas grade Ⅲ ischemia remained a strong predictor of severe arrhythmia.Conclusion Grade m ischemia on admission is associated with lower incidence of STR in patients with STEMI after thrombolysis and a strong predictor of severe arrhythmia.

Objective To investigate the value of posterior short segment peg-stick system plus pediele screw fixation in treatment of thoracolumbar fractures. Methods There were 38 patients invol-ving fractures at Tn in three patients, at T_(12) in 11, at L_1 in 15 and at L_2 in nine. There were three pa-tients with simple fractures of vertebral compression, 35 with burst fractures, 33 with thoracolumbar frac-tures combined with paraplegia. The patients with simple fracture of vertebral compression were treated by posterior short-segment peg-stick system plus pedicle screw fixation. While the patients with paraplegia and intraspinal occupancy were treated by posterior decompression, vertebral enlargement and bone graft-ing (between zygopophysis and transverse process) after fixation. Results All patients received a fol-low-up for average 14.5 months, which showed accurate position of pedicle screw and fine contour of the injured vertebra after reduction, with no loosening or breakage of fixators, chronic lumbar pain or loss of the height of fractured vertebra. Of all, 33 patients were accompanied by paresis. There was one patient at Grade A, six at Grade B, 16 at Grade C and nine at Grade D before operation. But there was one pa-tient at Grade A, one at Grade B, five at Grade C, 10 at Grade D and 16 at Grade E. Conclusions For thoracolumbar fractures especially vertebral burst fractures, posterior short segment speg-stick system plus pedicle screw fixation is an ideal treatment method, for it has the following advantages: no obvious loss of the height of the vertebra after operation, protection of the intact intervertebral disc under the in-jured vertebra and minor effect on range of motion of the lumbar vertebrae.

Objective To evaluate the effect of acupressure on chemotherapy-induced digestive tract reaction of malignant tumor patients.Methods We searched Pubmed,Medline,Embase,AMED,Cochrane Library,Cancerlit and Cinabl,China Biology Medicine disc (CBM),China National Knowledge Infrastructure (CNKI),VIP database (VIP)and Wanfang database,the databases were searched from the establishment of the database to March 2014.We identified randomized controlled trials (RCTs) and of acupressure on chemotherapy-induced digestive tract reaction for malignant tumor patients.Results In total,8 RCT,959 patients were included.Meta-analysis showed that compared with the no implementation of acupressure,acupressure could effectively reduce the frequency,duration and severity of chemotherapy-induced nausea,vomiting and retching.Meanwhile,acupressure could decrease anti-emetic medication dosage,but could not increase quality of life.Conclusions Acupressure can improve the digestive tract reaction of malignant tumor patients,alleviate the suffering of patients.Meanwhile acupressure couldn't increase the medical burden and mental burden of patients.More attention should be paid to the effect of acupressure on baseline level of state anxiety,functional state and more items.

Objective To develop fast detection techniques for the diagnosis of gonococcal infections.Methods Prokaryotic expression vector for Neisserial surface protein A (NspA) was constructed using the NspA gene cloned by PCR.Mice were immunized with the renatured recombinant NspA (rrNspA)to prepare antibodies against NspA.Western blot and ELISA was used to analyze the binding of NspA antibodies to lysate of gonococcal cells or to intact gonococci.Results NspA antibodies that were prepared by the rrNspA expressed in E.coli could bind to rrNspA,the natural NspA existing in gonococcal cells,or intact gonococci.Conclusion RrNspA and its antibodies have potential value in developing fast diagnostic kits for gonococcal diseases.

Background: and Purpose To evaluate whether the thrombus enhancement sign (TES) can be used to differentiate embolic large vessel occlusion (LVO) from in situ intracranial atherosclerotic stenosis (ICAS)-related LVO in the anterior circulation of patients with acute ischemic stroke (AIS). Methods: Patients with LVO in the anterior circulation who underwent both non-contrast computed tomography (CT) and CT angiography and mechanical thrombectomy were retrospectively enrolled. Both embolic LVO (embo-LVO) and in situ ICAS-related LVO (ICAS-LVO) were confirmed by two neurointerventional radiologists after reviewing the medical and imaging data. TES was assessed to predict embo-LVO or ICAS-LVO. The associations between occlusion type and TES, along with clinical and interventional parameters, were investigated using logistic regression analysis and a receiver operating characteristic curve. Results: A total of 288 patients with AIS were included and divided into an embo-LVO group (n=235) and an ICAS-LVO group (n=53). TES was identified in 205 (71.2%) patients and was more frequently observed in those with embo-LVO, with a sensitivity of 83.8%, specificity of 84.9%, and area under the curve (AUC) of 0.844. Multivariate analysis showed that TES (odds ratio [OR], 22.2; 95% confidence interval [CI], 9.4–53.8; P<0.001) and atrial fibrillation (OR, 6.6; 95% CI, 2.8–15.8; P<0.001) were independent predictors of embolic occlusion. A predictive model that included both TES and atrial fibrillation yielded a higher diagnostic ability for embo-LVO, with an AUC of 0.899. Conclusion TES is an imaging marker with high predictive value for identifying embo- and ICAS-LVO in AIS and provides guidance for endovascular reperfusion therapy.

Aged ; Humans ; Hyponatremia ; diagnosis ; Inappropriate ADH Syndrome ; diagnosis ; Lung Neoplasms ; diagnosis