Objective To study the psychological health state of parents of children patients with hand foot mouth disease and provide scientific basement for clinical nursing care. Methods Zung self- rating anxi-ety scale (SAS) and self-designed investigation scale were used to survey 98 parents of children patients with hand foot mouth disease,and selective nursing intervention was adopted. Results The anxiety scores of the parents were significantly higher than those of the normal mode, and their psychological symptom was influ-eneed by various factors. After the nursing intervention, the anxiety degree was significant different from that of before intervention. Conclusions Psychological health levels of the parents of children with hand foot mouth disease were markedly lower than those of healthy individuals. Psychological nursing care should not only in-clude children but also their parents in order to alleviate their bad mental state.

Objective To investigate the relationship between the incidence and grade of diabetic nephropathy (DN) and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus. Methods A total of 154 patients with type 2 diabetes mellitus (80 males and 74 females) were investigated, ocular fundus were examined after mydriasis, at the same day, blood urea nitrogen, creatinine, glycosylated hemoglobin, blood fat, serum albumin were determined, the microalbuminuria and the glomerular filtration rate were performed. Results The incidences of DR with each stage were significantly different according to different DN stages. Univariate analyses revealed that the disorder of DR was positively correlated with the duration of diabetes, microalbuminuria, blood cholesterol (P<0.01 or <0.05), and negatively correlated with the glomerular filtration rate (P<0.01). Conclusion The incidence OFDN and DR has the highly concordance, and their lesions have some parallel relationship.

Objective To evaluate the incidence and mortality of acute kidney injury (AKI) in coronary care unit (CCU),and to identify the risk factors of the incidence of AKI and the mortality of CCU patients.Methods A total of 414 patients in CCU from January 1,2014 to June 1,2015 at Zhongnan Hospital of Wuhan University were enrolled.Based on the KDIGO-AKI criteria,these patients were classified into two groups:NAKI group (patients without AKI) and AKI group.Clinical characteristics and laboratory data of two groups were compared.The risk factors of the incidence of AKI and the mortality of CCU patients was analyzed by logistic regression,and then the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of these risk factors.Results (1) Among 414 patients,136(32.9％) patients fulfilled the criteria for AKI,and 14.0％ patients in AKI stage 1,10.9％ in AKI stage 2 and 8.0％ in AKI stage 3.(2) The total CCU mortality was 15.0％.Mortality of AKI patients in the CCU was 33.3％,higher than 6.1％ in patients without AKI (OR=7.735,95％CI 4.215-14.196,P ＜ 0.001).The mortality worsened with increasing severity of AKI (22.4％ for AKI stage 1 group,37.8％ for AKI stage 2 group,45.4％ for AKI stage 3 group).(3) Anemia (OR=8.274,95％ CI 4.363-15.689),history of chronic illness (OR=2.582,95％ CI 1.400-4.760),APACHE]Ⅱ seores (OR=1.813,95％CI 1.739-1.895),male (OR=3.666,95％CI 1.860-7.226) were the independent risk factors for AKI,while the normal mean arterial pressure (MAP) (OR=0.292,95％CI 0.153-0.556) and normal estimated glonerular filtration rate (eGFR) (OR=0.166,95％CI 0.090-0.306) are the protective factors for AKI (all P ＜ 0.05).(4) AKI was the most powerful independent factor associated with the mortality of CCU patients (OR=7.050,95％ CI 2.970-16.735,P ＜ 0.001).Other independent risk factors for CCU mortality included history of chronic illness,ejection fraction and APACHE Ⅱ ≥ 15 scores (all P ＜ 0.05),while the normal MAP and normal eGFR were the protective factors (all P ＜ 0.05).(5) For predicting AKI,eGFR displayed an excellent areas under the ROC curve (AUC=0.815,P ＜ 0.001),and for CCU mortality,APACHE Ⅱ scores had the highest overall correctness of prediction (AUC=0.757 P ＜ 0.001).Conclusions CCU patients have high morbidity of AKI,which is the most powerful independent factor associated with the increased CCU mortality.The eGFR is the best predictor for AKI,and then through the evaluation of eGFR for CCU patients,we can evaluate high-risk groups,make early interventions and then improve the prognosis of CCU patients.

Objective To find out the epidemic characteristics and the prevalent tendency of transmission of HIV infection in Zhaotong City from 1997 to 2007. Methods Statistical analysis was applied to the data of 1997-2007 Zhaotong City local monitoring detection of HIV-infected persons and AIDS epidemic Tables Network reported. Results From 1997 to 2007, the cumulative report of the city's HIV-infected persons was 914 cases. Before 2002 the report was 144 cases as intravenous drug users. From 2003 to 2007 cumulative reports of 770 cases were infected with HIV, of which 524 were of local detection, accounting for the 68% of reports; field reports were 246 cases, accounting for 31.95%. 260 cases were intravenous drug users, accounting for 33.8%; 155 cases of heterosexual contact, accounting for 20.1%; 20 cases were of mother to child transmission, accounting for 2.6%; 335 were unknown cases, accounting for 43.5%. Report of infection from 0.19/100 000 in 1997 rose to 3.51/100 000 in 2007. The infection rate for migrant workers was 23.43/100 000. Conclusions From 1997 to 2007, transmission of HIV infection in Zhaotong City had a great change, and the rate of infection rose continually. The proliferation from high-risk population groups such as drug user to the general population increased rapidly, and it was the same case with floating population.

Objective To explore the clinical head nurses'effective competence through interviewing nursing supervisors by in depth interview method and to provide reference for constructing training content for clinical head nurses in Macau and Guangzhou.Methods In depth interview was carried out among 8 nursing supervisors from 2 hospitals in Macau and 9 nursing supervisors from 2 tertiary hospitals in Guangzhou.Content analysis was utilized through organizing records and then forming written documentations.Results The themes were drawn after the interview,which were good moral character accomplishment,good communication skill,prospective and creative thinking,favorable executive ability.Forwardlooking and innovative were significantly different in Macau and Guangzhou.Conclusions The effective clinical head nurses' competence is multi-faceted,the results can provide reference for selection,evaluation and training for head nurses.

In order to confirm the alteration and significance of cigarette smoke exposure on SP-A in rats, 20 Wistar rats were assigned randomly to two groups: an N group (n=10), and an S group (n=10). The ultra-structural change was observed by electron microscopy. The number of cells positive for SPA was by immunohistochemically measured. The mRNA expression in the lung tissues was determined by reverse transcription polymerase chain reaction (RT-PCR). The number of cells positive for SPA of the S group (0.52 +/- 0.05) was lower than that of the N group (0.72+/-0.06) (P<0.05). The levels of mRNA of SPA in the lung tissues of the S group (0.3522+/-0.0512) was significantly lower than that of the N group (0.4432+/-0.05628) (P<0.05). It is concluded that cigarette smoke alone decreased the level of SP-A and that might have an important effect on surfactant metabolism and the host defense functions of surfactant in the peripheral airways, which might play a crucial role in the development of chronic obstructive lung disease.
Gene Expression Regulation ; Immunohistochemistry/methods ; Lung/metabolism ; Microscopy, Electron ; Pulmonary Surfactant-Associated Protein A/*biosynthesis ; RNA, Messenger/metabolism ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Smoking/*adverse effects ; Tobacco Smoke Pollution/*adverse effects

AIM:To clone the SPA gene promoter and construct its luciferase report vector of SPA gene and to study its transcriptional targeting activity.METHODS:① The SPA gene sequence was acquired from GenBank,of which the upstream was analyzed according to bioinformatics.The results showed that the upstream region of SPA gene sequence about 163bp has the function of promoter.② The SPA gene promoter fragment was generated by polymerase chain reaction and then subcloned into the multiple clone site(MCS)of luciferase report gene vector pGL3-basic to generate the recombined plasmid pGL3-SPA.This fragment was also subcloned into pGL3-control to generate recombined plasmid pGL3-SPA-enhancer by replacing its primary SV40 promoter.③ pGL3-SPA,pGL3-SPA-enhancer,pGL3-control,pGL3-basic were cotransfected with pRL-TK into A549 cells and H441 cells.The luciferase activities were measured by dual luciferase reportor(DLR)system.RESULTS:Sequencing and restricted digestive results showed that SPA gene promoter was successfully cloned and identified,and also correctly subcloned into plasmid pGL3-basic and pGL3-control to construct its luciferase report plasmid pGL3-SPA and pGL3-SPA-enhancer,respectively.The transcriptional activity was high in H441 cells.CONCLUSION:The luciferase report system of SPA gene promoter is successfully constructed with high transcriptional activity.

Objective To analyze the living polymerization porcelain inlay restoration dental pulp large clinical efficacy of dental defects and infection prevention. Methods Forty-two cases patients with dental defects after the live pulp tooth of large teeth 48, were randomly divided into experimental group (24 teeth) and the control group (24 teeth). The experimental group tooth preparation, polymerization porcelain inlay restoration; Control group metal ceramic crowns, resin adhesive application RelyX Unicem 2-year follow-up and evaluated of the efficacy analysis infection prevention methods. Results The color matching, shape matching, secondary caries, marginal fit, wear and fracture strengths in the experimental group were better than the control group, the difference was statistically significant (P<0.05). Conclusion Living polymerization porcelain inlay restoration dental pulp excellent clinical efficacy large area of dental defects, pa-tients followed up show functions fine roles in shape, color matching after 2 years.

Objective: To study clinicopathologic features, prognosis and differential diagnoses of primary mucosal CD30-positive T-cell lymphoproliferative disorders of the head and neck(mCD30⁺ TLPD-head and neck). Methods: Three cases of mCD30⁺ TLPD-head and neck were collected from January 2014 to April 2017 at Sun Yat-Sen University Foshan Hospital. A literature review of mCD30⁺ TLPD of head and neck was provided. Results: All three cases presented with either bulging/exophytic nodule or mucosal ulcer/erosion. Morphologically, the tumor consisted of diffuse proliferation of uniform, large atypical mononuclear lymphoid cells that showed irregular or polymorphic nuclei with small nucleoli, and abundant pale or amphophilic cytoplasm. Hallmark cells with eccentric, horseshoe, kidney-like, or doughnut-shaped nuclei were present. While mitotic figures were present, no tumor necrosis was found. Eosinophilc infiltration was obvious in the background. The atypical large lymphoid cells had a immunophenotype of CD30⁺ /CD3⁺ /CD4⁺ /CD56^- along with positive cytotoxic molecule. While being negative for EBER/ALK/CD20/CD8, TCR rearrangement was found in 2 out of 3 cases. Three patients were cured after excision without relapse and metastasis.The two patients with TCR rearrangement didn′t show aggressive clinical course. Conclusions mCD30⁺ TLPD-head and neck is a rare benign lymphoproliferative disorder with spontaneous regression. It should be differentiated from cutaneous CD30⁺ anaplstic large cell lymphoma, lymphomatoid papulosis, and EBV-related mucocutaneous ulcer. Correct recognition of mCD30⁺ TLPD of head and neck is important to avoid overtreatment.

Objective To develop Chinese version of the Manchester patient safety framework, and evaluate the feasibility of its clinical application. Methods The Manchester patient safety framework (MaPSaF) was transformed into Chinese version by translation and back-translation together with inquiries from experts. The trial study was done firstly among 136 nurses in five pilot wards and followed by five times of focus-oriented group interviews. A semi-structured, in-depth interview was then performed in 12 randomly selected participants and acquired data were analyzed by category analysis. Result Two themes were abstracted: Chinese version of MaPSaF showed a good practicability, effectiveness and operability and it was effective for deepened understanding of patient′s safety culture. Conclusion The Chinese version of MaPSaF can be used for safety culture evaluation during nursing process in China.