OBJECTIVE:To observe therapeutic efficacy of Rhodiola wallichiana injection for swelling and pain in fracture pa-tients during perioperative period. METHODS:120 patients with closed fresh extremity long bones fracture were randomly divided into trial group and control group,with 60 cases in each group. Both groups received open reduction and plate fixation. Before and after op-eration,control group was given routine medicine and anti-inflammatory treatment;trial group was additionally given R. wallichiana in-jection 10 ml(250 ml added into 5%Glucose injection)intravenously,qd,on the basis of control group. A treatment course lasted for 10 d. The swelling degree before operation,1 d and 3 d after operation,pain degree on the day of operation and 1,2,3 and 7 d after operation,complication and average length of stay were observed and compared between 2 groups. RESULTS:The extent of swelling and pain,the incidence of complications and average hospitalization days of trial group were lower or shorter than control group,with statistical significance (P<0.05). CONCLUSIONS:R. wallichiana injection can promote blood circulation and remove blood stasis, ease the hydropsia and pain,relieve swelling and pain,reduce the incidence of complications and shorten hospitalization day.

OBJECTIVE:To improve the safety management level of high-risk drug Insulin injection in our hospital. METH-ODS:The standard management of Insulin injection(400 u/injection)was conducted by using PDCA(plan-do-check-action). The application of Insulin injection in wards was compared before and after six months of management. RESULTS:By strengthening training,improving ward baseline insulin management register system,adjusting the specification of insulin in information system, etc.,the application and storage of insulin became more standard;no expired drugs occurred;the rate of waste drug decreased from 95.06% before management to 22.00% after management,decreasing by 73.06%. CONCLUSIONS:PDCA cycle can im-prove the safety management of Insulin injection in wards effectively.

OBJECTIVE To study the clinical feature among patients with infectious fever and the antimicrobial resistance of infection pathogens.METHODS A retrospective analysis was carried out among 70 cases during recent 3 years.RESULTS The 70 strains of pathogens were isolated from blood and/or bone marrow cultures of 70 patients with infectious fever,40 strains(57.1%) were Gram-positive cocci,in which 8 strains were Staphylococcus aureus,and 32 strains were coagulase negative staphylococci(CONS);30 strains(42.9%) were Gram-negative bacilli,of which the Salmonella and Escherichia coli were the main microorganisms,53.1% of CONS were resistant to oxacillin.There were 5 strains of Gram-negative bacilli that were suspected to produce extended spectrum ?-lactamases(ESBLs),which were resistant to multiple antibiotics,the most active agent against these Gram-negative bacilli with ESBLs was imipenem.CONCLUSIONS The bacteria are mainly Grampositive cocci for the patients with infectious fever in the infectious wards.The Gram-negative bacilli with ESBLs show more multi-drug resistance,we should rationally select antibiotics and decrease the occurrence of drug resistant strains.

Objective To this study is intended to discuss its feasibility and advances in clinical techniques of obstetrics and gynecology. Methods Based on our hospital clinical teaching platform, a total of 348 medical students or clinical practicum doctors were randomly divided into PBL (Problem-based learning) traning group and clinical practice teaching mode group,respectively, after a period of three weeks of practices,the training effects are estimated by questionnaires, theoretical and clinical operations. Results After training, 174 students in simulation training group showed better in theory test,clinical operations and standardized patients examination than traditional clinical students. Conclusion The establishment of standardized simulation teaching system can effectively complement the lack of clinical practice, teaching resources, solve the visualization is not enough, the students hands-on opportunities for small problems,can enhance the training effect and improve the effectiveness of teaching.

Object To develop a capillary GC-MS analytical method for identification and deter- mination of ginkgolide A, B, C and bilobalide (GA, GB, GC and BB) in Ginkgo biloba L. leaves. Methods The leave samples were extracted in ultrasonic bath with ethanol-water (20∶80). The extract was purified by liquid-liquid extraction with ethyl acetate followed by solid-phase extraction on a column mixed with acid Al 2O 3, active carbon and celite. The terpenes were trimethylsilylated by BSTFA (with 1% TMCS) for 60 min at 100 ℃ and determined by GC-MS with HP-5 MS capillary column in the selected-ion monitoring mode. The intense fragment ions were chosen as monitoring ions for quantitative analysis. Cholesterol was used as an internal standard. Column temperature gradient: initial temperature 180 ℃, maintained 1 min, and then increased at 20 ℃/min to 260 ℃, and finally at 2 ℃/min up to 300 ℃, maintained 2 min. Results The retention times of GA, GB, GC and BB were 13.7,14.3,15.3 and 6.8 min, the major fragmentation ions (monitoring) were at m/z 537, 625, 713 and 455 (299), the average recoveries of GA, GB, GC and BB were 102.0%, 99.4%, 96.0%, 96.3%, RSD were 0.54%, 2.40%, 1.98% and 2.43%, respectively. Conclusion This method is repeatable, specific, accurate and easy to operate. It is adoptable for quality and quantity analysis of terpene lactones from G. biloba leaves.

Enthusiasm is an intrinsic motive that drives the ethical and moral aspects of nursing practice.Love is the source of enthusiasm.An enthusiastic nurse loves life,work and patients.Loving patients is essential to inflame passion for patient care.A desire for and pursuits of benevolence is the key to enthusiasm.Only the element of benevolence integrated into enthusiasm can nurses arouse a sense of compassion,responsibility and honour,which is then advanced to the realm of humanitarian-Heal the Wounded,Rescue the Dying.The essence of enthusiasm is sincerity,that is,providing patients wholehearted care rather than hypocritical act.Caring for patients is based on goodwill and altruism.Enthusiasm is also the driving force for nurses' creativity.It inspires a positive life,pushes to pursue self-actualization and propels continuous creation.

Objective To evaluate if the difference between oversea predicted values and healthy adult measurements of spirometry in shenyang.Methods 287 healthy adult volunteers underwent pulmonary function test.The measurements of spiromenty of 230 selected objects were compared to conventional oversea predicted values.Results In male group(154 objects),the measured values were as follows:VC(4.4?0.7)L,FVC(4.3?0.7)L,FEV1(3.5?0.6)L,FEF25%～75%(3.6?1.1)L/s,PEF(7.1?1.9)L/s,IC(2.8?0.7)L,respectively.In female group(76 objects),the measured values were as follows:VC(3.1?0.7)L,FVC(3.1?0.7)L,FEV1 2.5?0.6(L),FEF25%～75%(2.6?0.9)L/s,PEF(5.0?1.4)L/s,IC(2.1?0.7)L respectively.The measurements were 2%～26% and 2%～21% lower than the predicted values in male and female respectively.The major compared values had significant difference.Conclusion The major measured values of spirometry in healthy adult in shenyang were significantly lower than the oversea predicted values.Knudson or ECCS regression equations with appropriate correction factor were suggested to use in shenyang.

Objective To investigate the effect and mechanism of HPV16-E7 gene specific CRISPR/Cas (clustered regularly interspaced short palindromic repeat/CRISPR associated system) on the cell apoptosis and proliferation of human cervical cancer SiHa cell line.Methods HPV16 positive cervical cancer SiHa cells and HPV16 negative human embryonic kidney HEK293 cells were cultured and each of the cells were divided into 3 groups respectively in the experiment:the control group was untreated,the C9 group was transfected only with Cas9 plasmid,and the Cri group was cotransfected with guide RNA (gRNA) plasmid and Cas9 plasmid (1∶3).T-7endonuclease Ⅰ assay was used to detect double strand break (DSB) formation in SiHa cells.The apoptosis rates of SiHa and HEK293 cells were detected by flow cytometry (FCM).CCK-8 was used to evaluate the proliferation of SiHa and HEK293 cells.Western blotting was applied to detect E7 and pRb protein expression.Results The SiHa cells in Cri group showed DSB formation at 48 h after transfection.The apoptosis rate of Cri group at 48 h was 26.6％,higher than 2.6％ in control group (x2 =5.455,P =0.020) and 3.1％ in C9 group (x2 =6.279,P =0.012).The apoptosis rates of control,C9 and Cri group were 7.4％,7.6％,7.9％ for HEK293 cells respectively.Compared with the control and C9 group,the apoptosis rate of the Crigroup showed no statistical significance (x2 =0.032,P =0.858;x2 =0.034,P =0.853).After 72 h transfection,the inhibition rate of SiHa cells in Cri group was 29.4％,higher than 15.0％ in control group (x2 =22.481,P =0.000) and 18.0％ in C9 group (x2 =24.879,P =0.000).The inhibition rate of the HEK293 cells in Cri group was 3.2％,and it showed no significant difference compared with the inhibition rate of C9 group (2.2％,x2 =2.857,P =0.091) and control group (2.3％,x2 =3.438,P =0.064) respectively.Down-regulated expression of E7 protein and up-regulated expression of pRb protein were detected of the SiHa cells in Cri group compared with the control group,while the E7 protein and pRb protein level did not show difference in the C9 group.Conclusion CRISPR specifically targeting HPV16-E7 oncogene can promote apoptosis of SiHa cells,and inhibit the cell proliferation.It is speculated that CRISPR system may induce DSB event of E7 gene,and result into increased expression of tumor suppressor protein pRb.

Objective:To investigate the incidence trends and clinicopathologic characteristics of papillary thyroid cancer (PTC). Methods:A retrospective analysis was conducting using the following data:3,766 cases with thyroid disease in the People's Hospital of Wuhan University between January 2001 and July 2013;and 977 cases with thyroid cancer in the Hubei Cancer Hospital between Janu-ary 2006 and July 2013. Results:The incidence of thyroid cancer increased significantly since 2008, ranging from 14.94%to 18.10%(P<0.05). In particular, the PTC cases ranged from 85.33%to 90.89%(P<0.05). A total of 1,416 cases were diagnosed as PTC with a male to female ratio of 1:3.75. The positive rate of neck lymph node metastasis (NLNM) was significantly different in terms of gender and age (P<0.05). Significant differences were also found between the unifocal group and the multifocal group;the positive rate of NL-NM was 77.94%in the latter group. The rate of NLNM in PTC was 72.29%, which had higher significance compared with Hashimoto's thyroiditis or with nodular goiter. Conclusion: The incidence of thyroid cancer is increasing. Cases involving males aged below 45 years old and with>1 cm tumor diameter and multifocal PTC are more likely to be complicated with NLNM.

A method was developed for the determination of N-acetyl-S-( N-methylcarbamoyl ) cysteine ( AMCC) in human urine by online solid-phase extraction ( SPE )-high performance liquid chromatography ( HPLC ) . The separation of AMCC from the urine matrix was performed on AmoniPac PA Solid phase Extraction ( SPE ) column with 5 mmol/L KH2 PO4 as the mobile phase by left pump. Then the time was controlled to switch the valve to make only the section of sample containing AMCC transferred into the analytic column-Acclaim PAⅡ C18 . The determination was performed using gradient elution of 0. 1% H3 PO4 (containing 5% acetonitrile) and acetonitrile by right pump. The results showed that AMCC present good linear correlation in the range of 1 . 0-100 mg/L with a correlation coefficient of above 0 . 999 , the quantitation limit of the method was 0. 2 mg/L (with the sample inject volume =10 μL), the recoveries of spiked samples were in the range of 82 . 9%-85 . 9%, and the relative standard deviation ( n=6 ) of retention time and peak area were 0. 2% and 4. 0% respectively. Compared with offline SPE-HPLC, the proposed method was convenient, environmentally friendly, efficient and stable, and feasible for the detection of AMCC in 7 human urine samples.