Objective To discuss the systematic training method for new nurses in central sterile supply department(CSSD),in order to improve the training effects of new nurses and special practice ability,and make them to be qualified for jobs in CSSD.Methods 18 new nurses in CSSD were divided into the control group and the experimental group with 9 nurses in each group.The experimental group adopted systematic training method combining with unit tests and comprehensive evaluation.The control group chose the traditional training method.The testing results were compared between two groups.Results The experimental group all passed through the unit evaluation and comprehensive evaluation,could work independently after the training,got excellent achievement in comprehensive assessment of the department after 3 months on-the-job,and could finish all the work and solve various emergencies.4 passengers failed in unit assessment in the control group,and 3 failed in the comprehensive evaluation.The average results in the experimental group were obviously higher than that of the control group.Conclusions Scientific training content,the systematic training method,comprehensive evaluation method can avoid the blindness and arbitrariness in training and improve training effect.The implementation of unit access system and post access system in standardized training of new nurses can improve the study enthusiasm and strengthen the risk and responsibility consciousness of nurses,which is beneficial to the growth of new nurses and professional value guidance.

Objective To inveatigate the effect of 15-HETE, a metabolite of arachidonic acid, on isolated hypoxic pulmonary arterial ringa ( PARs) , trying to find appropriate treatment for pulmonary hypertension and its complications during anesthesia in order to avoid hypoxemia. Methods Sixteen healthy Wistar rats of either sex weighing (230 ? 10) g were randomly divided into two groups : A control group breathing fresh air (FiO2 =21%) and B hypoxia group breathing hypoxic air (N2 = 90% , O2 = 10% ) in a hypoxic box. After breathing hypoxic air for 9 days the animals were anesthetized. Heart and lungs were immediately removed and PARs (0.5-1.0 mm in diameter and 3 mm in length) were prepared. Four PARs were prepared from each animal. The PARs were suspended in baths filled with Krebs-Hensleit (K-H) solution maintained at 37℃ and aerated with 95% O2 and 5% CO2. Preload was gradually increased to 0.3 g in 30 min. The isometric tension was measured using a four-channel force-displacement transducer. 15-HETE was added to K-H solution and the concentration was gradually increased from 10-8 to 10-6 mol?L-1 at 5 min intervals. Contractility of PARs was analyzed by a software of Medlab 6.0. Concentration-tension curve was drawn and contraction rates were calculated. 2 mmol?L-1 4-AP, 10-2 mol?L-1 TEA and 10-6 mol?L-1 GLYB were added to separate K-H solution baths and 40 min later 15-HETE was added in order to detennine the effect of difierent potassium channel blockers on contraction response of PARs to 15-HETE. Results With increasing concentration from 10-8 to 10-6 mol?L-1 , 15-HETE increased PARs tension gradually in a dose-dependent manner from 106% ?6% to 139% ? 4% in group A and from 113% ?6% to 163% ?6% in group B. The difference in PARs tension between group A and B was statistically significant (P

Objective To evaluate the effect of acupointhot compress with warming moxibustion bag on treating radiation proctitis caused by radiotherapy in cervical cancer. Methods 78 patients of cervical cancer with acute radioactive proctitis caused by radiotherapy were divided into two groups according to the length of hospital stays. The experiment group was given compress Tianshu acupoint with warm moxibustion bag every day, along with drug and retention enema, while the control group was treated with drug and retention enema only. Then observe and evaluate the effect of different treatment on each group. Results The total effective rate of treating radiation proctitis in experimental group was 94.44%(34/36) which was superior to 76.19% (32/42) of the control group (χ2=4.962, P<0.05). The influence of tumor radiotherapy in experimental group was also superior to the control group, nine patients were forced to suspend to radiotherapy by (6.11 ± 1.96) days in the control group, while five cases were suspended to radiotherapy by (2.20±1.09) days in the experiment group (t=4.066,P<0.05). Conclusions Acupoint hot compress with warming moxibustion bag combine with retention enema have an advantage over retention enema only on radiation proctitis caused by radiotherapy in cervical cancer.

Objective To study the risk factors and prognosis of very/extremely low birth weight preterm (VLBW/ELBW) infants with bronchopulmonary dysplasia (BPD) during the first three years of life.Method From January 1st to December 31st,2012,a retrospective study was conducted on the VLBW/ELBW preterm infants with ＞ 28 days of hospitalization in the NICU of our hospital.The infants were assigned into BPD group (FiO2 ＞ 21％) and non-BPD group depending on the oxygen requirement on the 28th day after birth.The incidences of bronchitis,pneumonia,wheezing and re-hospitalization during the first three years of life were analyzed.The pulmonary function tests were performed at one-year-age.Independent-sapmles t test,Kruskal-wallis test and x2 test were used to compare the results between the two groups.Result A total of 72 patients were enrolled into this study.34 patients in the BPD group and 38 in the non-BPD group.The gestational age,birth weight and the use of INSURE technique of BPD group were significantly lower than non-BPD group,while the duration of hospital stays were longer than non-BPD group (P ＜0.05).The ratio of male,neonatal respiratory distress syndrome (RDS),patent ductus arteriosus (PDA),intrauterine infection,mechanical ventilation,nosocomial infection and the inhalation of high concentrations of oxygen were significantly higher in BPD group than non-BPD group (P ＜ 0.05).Incidences of bronchitis and wheezing during 0 ～ 1,1 ～ 2 and 2 ～ 3 years of age in the BPD were significantly higher than non-BPD group,separately.No significant differences existed in the incidences of pneumonia and re-hospitalization between the two groups.Pulmonary function test showed that the respiratory rate (RR) and peak tidal expiratory flow in the BPD group were significantly higher than non-BPD group,while the tidal volume,peak expiratory time and peak expiratory volume were significantly lower in BPD group than non-BPD group (P ＜ 0.05).Conclusion BPD often occurs in preterm infants with gestational age less than 32 weeks.It may cause impaired pulmonary function,characterized by obstruction in small airway,and increases the risk of bronchitis and wheezing during the first three year of life.

Objective To establish biological reference intervals of neonatal T lymphocyte subsets and IgG, IgA,IgMlevels in 24 -hour newborns in Guangxi.Methods Maternal history and neonatal clinical data were evalua-ted and recorded.Venous blood samplings were collected within 24 hours of birth and were sent for testing in half an hour.The neonates were divided into the early -preterm,the late -preterm and the term neonates group,1 1 0 cases for each group.The parturients were divided into Dexamethasone treatment group and without Dexamethasone treatment group.Data in neonates and the parturients and the sex were analyzed by SPSS 1 7.0 software and the biological refe-rence values were calculated.Results The two -sided reference intervals of 95% in the early -preterm group,the late -preterm group and the term neonates group were as follows:CD3 +:52.07 -88.92 g/L,58.1 6 -90.42 g/L, 56.1 5 -95.67 g/L;CD4 +:25.20 -59.26 g/L,31 .27 -72.91 g/L,28.44 -82.66 g/L;CD8 +:7.30 -36.26 g/L, 9.1 3 -38.49 g/L,1 1 .09 -48.99 g/L;CD4 +/CD8 +:0.34 -4.58,0.34 -4.58,0.32 -3.80;CD1 9 +:3.95 -27.59 g/L,4.04 -30.94 g/L,4.08 -38.70 g/L;NK cell:1 .34 -6.64 g/L,2.88 -8.92 g/L,3.07 -9.35 g/L;IgA:0.000 4 -0.039 6 g/L,0.000 0 -0.069 0 g/L,0.000 0 -0.069 0 g/L;IgM:0.001 6 -0.1 58 4 g/L,0.020 0 -0.1 40 0 g/L,0.020 0 -0.420 0 g/L;IgG:3.22 -1 0.98 g/L,1 .1 0 -1 4.62 g/L,5.00 -1 3.66 g/L.Moreover the ca-ses with Dexamethasone treatment were as follows:the late -preterm infants CD8 + 1 0.35 -40.33 g/L,NK 3.1 0 -9.46 g/L,term NK 6.60 -9.50 g/L;those in without Dexamethasone treatment:the late -preterm infants CD8 +8.42 -34.96 g/L,NK 2.94 -7.80 g/L,term NK 2.98 -8.94 g/L;according to gender,the males in the late -pre-term infants CD8 + 8.26 -35.66 g/L,term CD3 + 51 .90 -92.94 g/L;females in the late -preterm infants CD8 +1 1 .08 -40.68 g/L,term CD3 + 61 .1 0 -96.1 4 g/L.Conclusions Testing values of neonatal T lymphocyte subsets and IgG,IgA,IgM levels in 24 -hour newborns in Guangxi disperse largely and show some differences among the early -preterm neonates,the late -preterm neonates and the term neonates,and maternal Dexamethasone treatment during pregnancy and gender play a role in neonatal immunity.

Objective The joint latent class model(JLCM)was applied to study the reversion of mild cognitive impairment(MCI)to normal cognition(NC),providing a methodology reference for the longitudinal study of chronic diseases.Methods The JLCM model consisted of three sub-models:the latent class sub-model adopted multi-class logistic regression to estimate the latent classes;the longitudinal process sub-model adopted linear mixed model to describe the longitudinal cognitive measurement;and the survival process sub-model adopted proportional risk model to fit the cognitive process.Goodness of fit was based on information criterion,posterior classification,comparison between predicted value and observed value and conditional independence assumption.Results The MCI population was divided into two latent classes based on the JLCM model,including 783(92.88%)and 60(7.12%),respectively.The latent class sub-model showed that gender,marital status,APOE4 and FAQ had statistical significance for the determination of latent classes.The longitudinal process sub-model showed male(β=-0.685,95%CI:-1.144,-0.226),being single(β=0.743,95%CI:0.200,1.286),not carrying APOE4(β=-1.201,95%CI:-1.636,-0.766)and without functional impairment(β=-1.868,95%CI:-2.095,-1.641)had higher MMSE scores.The survival process sub-model showed that high education level(HR=1.264,95%CI:1.134,1.395),being single(HR=1.593,95%CI:1.286,1.899)and not carrying APOE4(HR=0.453,95%CI:0.043,0.862)were protective factors for reversion to NC in MCI patients.Conclusion JLCM model has good application value in the study of chronic diseases such as cognitive impairment.

Objective To evaluate the levels of total serum bilirubin(TSB),amplitude integrated electroencephalogram(aEEG) monitoring and brainstem auditory evoked potential(BAEP) individually and in combination for the early diagnosis of neonatal acute bilirubin encephalopathy by receiver operating charac-teristic( ROC) curve. Methods Clinical data was retrospectively analyzed. A total of 152 infants were diag-nosed with hyperbilirubinemia,including 119 cases of non-bilirubin encephalopathy group and 33 cases of bil-irubin encephalopathy group. The detection results of peak serum bilirubin,aEEG,BAEP combined with the three methods were determined with ROC curve analysis. Results The areas under ROC curve of TSB lev-el,aEEG,BAEP and in combination were 0. 900,0. 738,0. 767,0. 925,respectively,the corresponding sensi-tivity(specificity) in the cut-off point were 90. 91%(78. 15%),87. 88%(59. 66%),65. 52%(87. 91%), 93. 10%(82. 42%),respectively. It showed that the area under ROC curve of the maximum,the comprehen-sive assessment in diagnostic sensitivity and specificity of the combination of three methods were better than any single detection method by ROC curve. Conclusion The methods of TSB level,aEEG and BAEP play an important role in the diagnosis of neonatal bilirubin encephalopathy,and combination with the three meth-ods can improve the accuracy of diagnosis.

Objective To study the clinical and genetic characteristics of congenital hyperinsulinism (CHI).Method From November 2016 to November 2018,a cohort of 21 patients with CHI were retrospectively reviewed in our hospital.The second generation sequencing was performed on Ion torrent platform to identify the genetic etiology of this disease.Result The average birth weight was 3 748 g.Overall,11 of the 21 patients (52.4％) were large for gestational age (＞ Pg0),and 90.5％ (19/21) onset within 3 days after birth.Seizures occurred in 7 cases (33.3％).Diazine was effective in alleviation in 6 patients,octreotide was effective in 8 patients,and diazine and octreotide were ineffective in 7 patients.11 patients underwent 18-fluoro-l-dopa PET-CT scan,indicating focal islet cell proliferation in 8 patients and diffuse islet cell proliferation in 3 patients.8 focal cases accepted the partial pancreatectomy (7 cases who failed to respond to drug therapy,1 case who received octreotide had significant liver damage),and all of these 8 cases were confirmed with focal islet cell proliferation by postoperative pathology.7 cases had normal glucose level after surgery,while 1 case developed insulin-dependent diabetes.Patients of 3 cases with diffuse islet cell proliferation had no consent for surgery.Gene mutations were identified in 61.9％ (13/21) of patients (12 cases of ABCC8 gene and 1 case of KCNJ11 gene).15 sequence changes were identified (14 in ABCC8 and 1 in KCNJ11).3 new ABCC8 gene mutations (exon13:c.1822C ＞ T,p.Q608X;exon22:c.2691delC,p.W898Gfs*5;exon33:c.4039C ＞T,p.Q1347X),and 1 new KCNJJ11 gene mutation (exon1:c.629T ＞ A,p.H315Y) were firstly reported.Conclusion Partial pancreatectomy is an effective treatment for those CHI not responsive to drug,however,with an attendant risk of developing diabetes.Mutations of ABCC8 gene and KCNJJ11 gene are the main pathogenic genes of CHI.Patients with different gene mutations may have different responses to drug treatment.Therefore,it is necessary to improve gene testing in clinical practice to guide treatment and prognosis.3 new ABCC8 gene mutations and 1 new KCNJJ11 gene mutation were first reported,which expand the spectra of gene mutation.

Objective:To observe the effects of acupuncture on the expression of circRNA_011989 and circRNA_009775 in the hippocampal tissue of cerebral ischemia/reperfusion injury(CIRI)rats.Methods:CIRI model rats were prepared by the thread bolus method and treated by means of acupuncture(AC).The Garcia score was used to assess the neurological function.TTC staining was used to detect the volume ratio of cerebral infarction.The target prediction website was used to predict the miRNAs and corresponding mRNAs bound by circRNA_011989 and circRNA_009775,and Cytoscape was used to construct the circRNA-miRNA-mRNA co-expression network.The expression of circRNA_011989,circRNA_009775,miR-466b-5p,miR-3065-3p,Rims1,and Slc30a3 in the hippocampal region of the ische-mic side was detected by real time RT-PCR.Results:Compared with CIRI group,Garcia score of rats in CIRI+AC group was significantly increased(P＜0.01),and the infarct volume decreased.The expressions of circRNA_011989,circRNA_009775,Rims1,and Slc30a3 in right hippocampus were up-regulated(P＜0.05,P＜0.01),but the miR-466b-5p and miR-3065-3p were down-regulated(P＜0.05).Conclusion:Acupuncture may significantly ameliorate the neurological deficit symptoms in CIRI rats by upregulating the expression of circRNA_011989 and circRNA_009775,and the specific mechanism may be related to the activation of circRNA_011989/miR-466b-5p/Rim.s1 and circRNA_009775/miR-3065-3p/Slc30a3 axis related.

Objective To evaluate the safety and efficacy of botulinum toxin type A for injection in the treatment of post-stroke upper limb spasticity (dosage was 200 U,or 240 U if combined with thumb spasticity).Methods The study was a multi-center,stratified block randomized,double-blind,placebocontrolled trial.All the qualificd subjects were from 15 clinical centers from September 2014 to February 2016.They were randomized (2∶1) to injections of botulinum toxin type A made in China (200-240 U;n =118) or placebo (n =60) in pivotal phase after informed consent signed.The study was divided into two stages.The pivotal trial phase included a one-week screening,12-week double-blind treatment,followed by an expanded phase which included six-week open-label treatment.The tone of the wrist,finger,thumb flexors was assessed at baseline and at weeks 0,1,4,6,8,12,16 and 18 using Modified Ashworth Scale (MAS),disability in activities of daily living was rated using the Disability Assessment Scale and impaction on pain,muscle tone and deformity was assessed using the Global Assessment Scale.The primary endpoint was the score difference between botulinum toxin type A and placebo groups in the tone of the wrist flexor using MAS at six weeks compared to baseline.Results Muscle tone MAS score in the wrist flexor of botulinum toxin type A and placebo groups at six weeks changed-1.00 (-2.00,-1.00) and 0.00 (-0.50,0.00) respectively from baseline.Botulinum toxin type A was significantly superior to placebo for the primary endpoint (Z =6.618,P ＜ 0.01).The safety measurement showed 10 subjects who received botulinum toxin type A had 13 adverse reactions,with an incidence of 8.47％ (10/118),and three subjects who received placebo had three adverse reactions,with an incidence of 5.00％ (3/60) during the pivotal trial phase.All adverse reactions were mild to moderate,none serious.There was no significant difference in adverse reactions incidence between the botulinum toxin type A and the placebo groups.During the expanded phase three subjects had four adverse reactions and the incidence was 1.95％.All adverse reactions were mild,none serious.Conclusion Botulinum toxin type A was found to be safe and efficacious for the treatment of post-stroke upper limb spasticity.Clinical Trial Registration:China Drug Trials,CTR20131191