Objective To investigate effect of applying nursing flowchart in the post-anesthesia care unit(PACU).Method The nursing flowchart in PACU are as follous,including a ventilator connection,monitoring instrument connection,handover of pipeline and skin and training for PACU nurses.Results After application of the nursing flowchart,the nursing time for postoperative patients was reduced from 7.0 min to 4.0 min.No nursing risks and adverse events occurred.Conclusion Application of nursing flowchart in PACU can improve the quality of nursing and enhance patients safety.

Objective:To explore the quality of life and its influencing factors in patients with hyperthyroidism.Methods:From June 2017 to June 2019, patients with hyperthyroidism who were first diagnosed in the First Affiliated Hospital of Hainan Medical College were selected as the research objects, and the quality of life of the patients was assessed by the Chinese version of World Health Organization Quality of Life Brief Scale (WHOQOL-BREF). Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate the psychological status of the patients. Univariate analysis was used to compare the differences of general information (age, gender, course of disease, marital status, education level, occupation, monthly family income, family relationship, thyroid ophthalmopathy, laboratory examination, thyroid crisis, anxiety level, and depression level) among patients with different quality of life. Multivariate logistic regression analysis was used to analyze the related factors affecting the quality of life of patients with hyperthyroidism.Results:There were 120 patients, aged (45.42 ± 6.38) years old, including 42 males and 78 females. The WHOQOL-BREF score was (76.58 ± 10.42) points, ranging from 25 to 106 points. Among them, 49 cases (40.83%) had high scores (≥80 points) and 71 cases (59.17%) had low scores (<80 points). Univariate analysis showed that there were differences in the quality of life among different marital status, education level, monthly family income, family relationship, thyroid ophthalmopathy, FT 3, FT 4, anxiety level and depression level ( P < 0.05). Multivariate analysis showed that thyroid ophthalmopathy, divorce or widowhood, monthly family income < 2 000 yuan, family disharmony, depression or anxiety, abnormal FT 4 and FT 3 were the risk factors affecting the quality of life of patients with hyperthyroidism ( P < 0.05). Conclusion:The overall quality of life of patients with hyperthyroidism is low, especially those with thyroid ophthalmopathy, divorce or widowhood, monthly family income < 2 000 yuan, family disharmony, depression, anxiety, FT 4 or FT 3 abnormalities.

Objective:To observe the effect of low-expression or over-expression of NUP88 gene on the proliferation and invasion ability of breast cancer cell line BT-20.Methods: NUP88 recombinant adenovirus expression vector and NUP88 RNAi adenovirus vector were transfected into breast cancer BT-20 cells to obtain BT-20 cells over-expressing NUP88 and BT-20 cells lower-expressing NUP88 and then detected the expression of NUP88 mRNA and NUP88 protein.After that,the apoptosis of BT-20 cells was detected by flow cytometry and the invasion and metastasis of BT-20 cells were detected by Transwell invasion assay.The expression of apoptosis protein and invasion and metastasis proteins were detected by Western blot.Results: BT-20 cell with the over expression levels of NUP88 mRNA and NUP88 protein and BT-20 cell with the low expression levels of NUP88 mRNA and NUP88 protein were structured.The over-expression of NUP88 gene led to proliferation rate and the number of invasive cells were significantly higher than BT-20 cells,apoptosis cells were significantly lower than BT-20 cells(P<0.05).However,the low-expression of NUP88 gene led to proliferation rate and the number of invasive cells were significantly lower than BT-20 cells,apoptosis cells was significantly higher than BT-20 cells(P<0.05).The over-expression of NUP88 gene led to Bcl-2 and β-catenin level were significantly higher than that of BT-20 cells,and Bax and E-cadherin level were significantly lower than that of BT-20 cells(P<0.05).However,the low-expression of NUP88 gene led to Bcl-2 and β-catenin level were significantly lower than that of BT-20 cells,and Bax and E-cadherin level were significantly higher than that of BT-20 cells(P<0.05).Conclusion: NUP88 gene regulates the proliferation and invasion and migration ability of breast cancer cells by regulating the expression of Bax,Bcl-2,E-cadherin and β-catenin.It has an important significance in the target treatment of breast cancer.

Objective To formulate an evidence-based nursing scheme of a pin site nursing method to reduce the incidence of pin site infection among patients with bone pin surgery. Methods Under the principle of PICO, the issue was put forward aiming directly at patient′s clinical manifestations. By some database retrieval and evaluate the retrieval of literature evidence, the optimal evidence will be applied to the patients and the curative effect were observed. Results A total of 1 systematic review, 1 cohort study and 9 randomized controlled trials (RCTs) were included. According to the available evidence mentioned herein and patient′s conditions, they developed a new pin site nursing method and applied to patients. Seven days later, the two pin sites with infection symptoms obviously improved, with decreasing secretion, without skin redness and pain, and the temperature of skin was normal. The other six pin sites without infection did not occur infection. Conclusions The patients with pin sites using based iodine disinfection and sterile gauze strip winding better than the conventional alcohol drop pin site in reducing infection.

Objective:To study the drug resistance patterns of Bordetella pertussis in vitro, and to know the clinical characteristics of pediatric pertussis and evaluation the treatment outcomes, which may provide references for experiential diagnosis and treatment of this disease. Methods:Nasopharyngeal swabs of the hospitalized children with suspected pertussis in Children′s Hospital, Zhejiang University School of Medicine in 2017 were collected for culture. And the clinical data of the children were collected. The strains were identified by pertussis-specific antiserum agglutination and finally confirmed by mass spectrometry. The drug sensitivity test was performed using the E-test method. The efficacy of therapy with antibiotic was evaluated after two weeks of treatment. Statistical analysis was performed with Mann-Whitney U test and chi-square test. Results:Of 1 029 children, 211 (20.5%) nasopharyngeal swabs were positive for Bordetella pertussis culture, and the isolation rate of the specimens was highest (31.2%, 45/144) in July. Of the 211 pertussis patients, 105 (49.8%) were male and the age were 3.8 (2.2, 6.9) months, 114 (54.0%) were not vaccinated with pertussis diphtheria tetanus mixed vaccine and 192 (91.0%) were prescribed with previous antibiotics. There were 142 (67.3%) children from families with two or more than two children, and 136 (95.8%) of which were the youngest siblings. One hundred and fifty-nine (75.4%) patients had paroxysmal cough and 61 (28.9%) had whooping. The white blood cell counts were higher than 20×10 9/L in 94 (44.5%) patients, and the lymphocyte counts were higher than 10×10 9/L in 97 (46.0%) of patients. The drug susceptibility results showed that 138 (65.4%) strains were against erythromycin, azithromycin and clindamycin with minimum inhibitory concentration (MIC)>256.000 mg/L. The MIC 90 of the isolates to ampicillin, ceftriaxone, cefoperazone/sulbactam, meropenem and trimethoprim/sulfamethoxazole were 0.190 mg/L, 0.190 mg/L, 0.094 mg/L, 0.094 mg/L and 0.750 mg/L, respectively. All strains had a MIC of <0.016 mg/L for piperacillin/tazobactam. After treatment, symptoms were improved in 195(92.4%) patients when they were discharged from hospital. Seventy-six (57.1%) children whose symptoms did not improve after seven-day treatment with macrolides, were prescribed with other antibiotics or other antibiotic with macrolides in combination. Compared with the patients treated with macrolides, more patients treated with cefoperazone/sulbactam or piperacillin/tazobactam had negative nasopharyngeal culture results after two weeks of therapy (46/48(95.8%) vs 46/57(80.7%)), or on day seven (45/46(97.8%) vs 39/47(83.0%)) and on day 14 (45/45(100.0%) vs 41/47(87.2%)) since discharged. The differences were all statistically significant ( χ2=5.50, 5.86 and 6.15, respectively, P=0.019, 0.015 and 0.013, respectively). Conclusions:The majority of children with pertussis do not have whooping, and the resistant rate of Bordetella pertussis to macrolides is high. Further study is needed to evaluate the feasibility and reasonability of cefoperazone/sulbactam and piperacillin/tazobactam in treating pediatric pertussis caused by macrolides-resistant Bordetella pertussis.

AIM: To observe the effect of osthole on tricalcium phosphate (TCP) particles-induced calvarial osteolysis in vivo.METHODS:Male ICR mice were randomly divided into sham group , TCP group and osthole group .A mouse calvarial model of osteolysis was established by TCP particles .On the second postoperative day , osthole (20 mg/kg) was locally injected into the calvarium under the periosteum 3 times a week.Two weeks after osthole treatment , blood and calvaria were collected to determine the level of bone turnover markers such as alkaline phosphatase ( ALP) , osteocalcin and tartrate-resistant acid phosphatase ( TRACP) .The periosteum was performed to examine the release of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and IL-1βby ELISA.The calvaria was obtained for histological and molecular analyses.RESULTS:Data from HE and TRACP staining revealed that osthole prevented TCP particles-induced obvious increase in osteoclastogenesis and resorption area in the metaphysis of mouse calvaria .Osthole treatment increased ALP ac-tivity and osteocalcin level , and dncreased the activity of TRACP in the mouse serum compared with TCP group .Further-more, TCP particles-induced the releases of TNF-α, IL-6 and IL-1βwere significantly suppressed by osthole treatment .In addition, Western blot demonstrated that endoplasmic reticulum ( ER) stress markers such as glucose-regulated protein 78 (GRP78) and CAAT/enhancer binding protein homologous protein (CHOP) were significantly up-regulated in TCP parti-cles-implanted calvarial mice , indicating that TCP particles triggered an ER stress response in the mouse calvarial osteolysis model , which obviously attenuated by osthole .CONCLUSION:Osthole inhibits TCP particles-induced calvarial osteolysis in mice, which is mediated by inhibition of ER stress signaling pathway .

AIM: To evaluate the effect of inhibiting ubiquitin-specific protease 14 (USPl4) activity on oxidative stress induced by H2O2 of H9c2 cells.METHODS: The H9c2 cells were incubated with H2O2 at 25 μmol/L for 2 h to establish the oxidative stress injury model.The cells were divided into control group, H2O2 group, IU1 group (25 μmol/L or 50 μmol/L) and IU1+ H2O2 group.The H9c2 cells activity was measured by MTS assay.The level of intracellular reactive oxygen species (ROS) and cell survival rate were analyzed by flow cytometry assay.The changes of the mitogen-activated protein kinase (MAPK) family related proteins were detected by Western blot.RESULTS: Compared with control group, the cell activity and the viability rate in H2O2 group were decreased (P<0.05), while the intracellular ROS, the protein levels of Bax/Bcl-2, P53, p-ERK1/2, p-JNK and p-P38 were increased (P<0.05).Compared with H2O2 group, the cell activity and the viability rate of the H9c2 cells in IU1+H2O2 group were increased (P<0.05), while the intracellular ROS, the protein levels of Bax/Bcl-2, P53, p-ERK1/2, p-JNK and p-P38 were decreased (P<0.05).CONCLUSION: Inhibition of USPl4 activity reduces the oxidative stress injury of the H9c2 cells.The mechanism may be related to inhibition of the MAPK signaling and down-regulation of apoptosis related proteins.

Objective:To study the possible immune escape mechanisms of HCoV-OC43 from human dendritic cells(DC).Methods:HCoV-OC43 was isolated from clinical specimen using BSC-1 cells and identified by Real-time PCR,and the cytopathic effect was observed by phase contrast microscope.DCs were induced in vivo using hu-GM-CSF and IL-4 cytokines,and after 7 days of differentiation,DCs were infected by HCoV-OC43.The morphology of HCoV-OC43 infected DC was observed by transmission electron microscope,and the cytokines related to DC functions were detected by Real-time PCR after infection.DC proportion and function related co-stimulatory molecules were analyzed by flow cytometry.Results:In vitro HCoV-OC43 infected human DC model was successfully built.HCoV-OC43 can infect DC and generate immune response of DC in vitro,but no virus nucleonic acid could be detected in culture supernatant.The DC expression of IFN-α,IFN-β,CCL3 and CCL5 were significant decreased when infected with HCoV-OC43,but the expression of costimulatory molecules including HLA-DR,CD1c and CD86 were not affected by HCoV-OC43 infection.Conclusion:Human DC could be infected by HCoV-OC43 and generate immune response,but could not produce progeny virus.HCoV-OC43 may escape from immune response by suppressing the expression of IFN-α and other inflammatory cytokines and chemokines in DC.

0.05).Conclusion In-vitro-cultured CB has good effects in the treatment of apoplexy.Neither in-vitro-cultrued CB nor natural CB for apoplexy has obvious adverse reaction.

0.05).The results of electrocardiography and the laboratory ex-amination showed that neither ANWin cluding natural Calculus Bovis nor A NWincluding in -vitro cultured Calc ulus Bo-vis had obviously toxic and side effe cts in treating epidemic encephalitis B.Conclusion ANW including in -vitro cul-tured Calculus Bovis has an markedly effect in the treatment of epidemic e ncephalitis B.