The status quo of pain,trigger mechanism of pain,the manner of pain valuation and painalleviating measures during wound dressing were analyzed by checking literatures at home and abroad.These studies implied that the dressing-related pain impacted not only wound healing but also patients' daily life.At the same time,the studies and clinic practice of dressing-related pain in China were relatively deficient,therefore it is important that clinic practitioner should pay more attention to awareness of dressing-related pain and pain causes and take measures to relieve pain.

Securin is a multifunctional protein which is encoded by PTTG gene.In the metaphase to anaphase transition during mitosis,Securin is involved in sister chromatid separation.The aberrant expression of Securin is found in many endocrine and related cancers,such as pituitary tomour,thyroid cancer,ovarian cancer,colon cancer et al.The function of Securin in cancer is related to its gene transactivation and association with other poteins like p21,p53.

Objective To analyze the effect and the problems of the comprehensive application of quality management tools in order to improve nursing quality and ensure patient safety.Methods To summarize the implementation of Plan,Do,Check,Action(PDCA),quality control circle(QCC),root cause analysis(RCA),healthcare failure mode and effect analysis(HFMEA) in the nursing quality improvement.Aiming at problems arising in application process,the measures such as systematic training of quality management knowledge,case demonstration,standardized evaluation throughout the whole process,holding competition activities,inviting experts to give immediate guidance were applied.Results Among 1 798 PDCA and QCC programs,the result of 1 795 programs reached the target value,3 substandard programs reached the expected outcome finally after cause analysis,procedure break down and adjust of improvement contents.No nursing error or adverse events occurred.The indicators of nursing quality improved and patient satisfaction was 98.58％,which got the third position among all national hospitals.Conclusions The comprehensive application of four quality management tools was helpful in enhancing the effect of nursing quality improvement.

OBJECTIVE To investigate the existence of genes for beta-lactam antibiotic resistance and for aminoglycosides modification enzymes(AMEs) in Pseudomonas aeruginosa(PAE) isolates from ICU patients and analyze the homology among strains.METHODS ?-Lactamase genes including TEM,SHV,OXA-10,PER,VEB,GES,CARB,IMP,VIM,SPM,GIM,DHA,FOX,MOX and oprD2,were detected by PCR amplication in 21 PAE isolates.The genes for AMES including aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6′)-Ⅰ,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰwere determined by PCR amplification as well.RESULTS Among 21 isolates 21(100%),2(9.5%),1(4.8%),2(9.5%)and 4(19.0%) were positive for TEM,SHV,GES,CARB and VIM genes,respectively.The deletion of oprD2 gene was found in 14 out of 21 strains.Other ?-lactamase genes were absent in all isolates.As for AME genes,aac(3)-Ⅱ,aac(6″)-Ⅰ,aac(6)-Ⅱ,ant(3″)-Ⅰ,ant(2″)-Ⅰ and aac(3)-Ⅰgenes were present in 19.0%,23.8%,9.5%,4.8%,and 19.0% of 21 isolates,However,aac(3)-Ⅰ gene was no position in any isolates.CONCLUSIONS P.aeruginosa carries various beta-lactamase and AME genes in ICU patients.Genetic cluster analysis suggested that clonal propagation result in nosocomial infection of PAE.

Objective To evaluate the efficacy and safty of antiviral treatment for chronic hepatitis B ( CHB ) patients in second trimester of pregnancy.Methods Seventy-nine CHB patients in second trimester of pregnancy were collected from Hangzhou First People’ s Hospital and Xixi Hospital of Hangzhou during January 2010 to December 2013.Patients were divided into antiviral treatment group ( n=47) and the control group (n=32) according to their own wishes.Patients in antiviral treatment group were given lamivudine or telbivudine treatment plus hepatoprotective medication, while those in control group were only given hepatoprotective medication.All pregnant women were observed for 12 weeks after childbirth and the neonates were followed-up for 6 months after birth.The liver function, HBV DNA loads, HBV serological markers were measured;adverse effects during pregnancy, blocking rates of mother-to-child transmission and the growth of neonates were documented.t test or Chi-square test was used for statistical analysis.Results Alanine aminotransferase ( ALT) normalization rate and HBV DNA negative rate in antiviral treatment group before childbirth were 88.6%(39/44) and 84.1%(37/44) , while those in the control group were 60.0%(18/30) and 0 (χ2 =8.27 and 50.46, P<0.05).After 12 weeks of childbirth, ALT normalization rate and HBV DNA negative rate in antiviral treatment group were both 100.0% (44/44), which were higher than those in control group (90.0%and 0) (χ2 =4.59 and 74.00, P<0.05).HBeAg seroconversion was observed in 1 (2.8%) and 4 (11.1%) patients in antiviral treatment group before and 12 weeks after childbirth, but it was not observed in the control group.The difference in HBeAg seroconversion rate bwteen two groups was not of statistical significance (P>0.05).No patient in antiviral treatment group terminated pregnancy due to abnormal liver function or adverse effect of drugs, while 2 out of 30 patients (6.7%) in the control group terminated the pregnancy, but the difference between two groups was not of statistical significance (χ2 =1.01, P >0.05).Mother-to-child transmission of HBV was successfully blocked in antiviral treatment group, while 3 cases (11.5%) in control group were failed (χ2 =5.19, P<0.05).No significant differences in gestational age, body mass, body length, Apgar score between two groups were observed (t=0.65, 0.84, 0.25 and 0.77, P>0.05).Conclusion Antiviral treatment can improve liver function, inhibit HBV replication and reduce the risk of mother-to-child transmission, and is safe for CHB patients in second trimester of pregnancy.

Objective To explore the value of contrast-enhanced ultrasonography(CEUS) in brain injuries. Methods ① Models of graded brain trauma were created in brains of 10 healthy mongrel dogs after the animals were anesthetized and the cranium were removed. Conventional ultrasonography(US) and CEUS were performed to observe the characteristics of traumatic region. ② Thirteen patients with traumatic brain injuries were collected to perform intraoperative ultrasonography. The location, depth, size, internal echo and boundary of traumatic brain injuries were clearly displayed. Eight injury sites were chosen to undergo CEUS. Results ① Twelve injury sites in brains of 10 dogs were detected,and CEUS were peformed in 10 lessions, of which 1 was diagnosed with cerebral contusion, 1 with cerebral contusion and cerebral hemorrhage, 7 with intracerebral hematoma, 2 with ventricular hematoma, 1 with blood vessels in intracerebral hematoma. ② Fifteen lesions were detected by preoperative CT scan, but 18 lessions were detected by intraoperative ultrasound. During operation epidural hematomas in 4 cases were detected. After CEUS,the area of lessions was clearly revealed to be extended, the hemorrhage area was exempt from enhancement while peripheral normal cerebral tissue was homogenously enhanced. Conclusions Conventional ultrasonography could display brain injuries. In case of accurate intraoperative encephalocele, intraoperative untrasound conduces to discover delayed intracranial hematoma. Different traumatic brain injuries had their special CEUS findings.

Objective To establish an indicator system for performance assessment of women and children health care institutions,and provide basis for performance management of such institutions.Methods In this study,literature searching,expert discussion,Delphi method,coefficient of variation method,correlation analysis,principal components analysis,factor analysis and cluster analysis were used to establish the indicator system.In addition,expert scoring and CRITIC methods were called into play to calculate the weight coefficient of each index,and to test the validity and reliability of such an indicator system.Results Thanks to the framework of this indicator system,we set up six class 1 indicators,including heahhcare quality,healthcare efficiency,quality and efficiency of public health service,social efficiency,economic benefit,and development potential.Conclusions Scientific studies can help us build a scientific and practical general performance assessment indicator system applicable to women and children care hospitals at all levels.

The protein product of metastasis-associated in colon cancer 1 (MACC1) gene induces the activation of hepatocyte growth factor/mesenchymal-epithelial transition factor (HGF/c-Met) signaling pathway through transcriptionally activating c-Met gene and upregulating its expression to further promote tumor invasion and metastasis.High level expression of MACC1 is associated with the occurrence and metastasis of a wide variety of human tumors, such as colon cancer, gastric cancer, liver cancer, lung cancer, ovarian cancer etc.In addition, the overexpression of MACC1 is also closely associated with clinical TNM stages and distant metastasis.Thus, MACC1 can serve as an independent indicator of tumor metastasis and prognosis, and become a new target for gene therapy.

Objective To evaluate the effect of peritoneal resuscitation (PR) with pyruvate-based peritoneal dialysis solution (PDS) on liver injury in a rat model of hemorrhagic shock.Methods Fifty healthy male Sprague-Dawley rats,weighing 200-250 g,were used in this study.The animals were anesthetized with pentobarbital sodium,tracheostomized and mechanically ventilated.Hemorrhagic shock was induced by withdrawing blood from the left femoral artery at a rate of 0.6 ml/min within 10 min until mean arterial pressure (MAP) was reduced to 30-40 mmHg which was maintained for 60 min.The animals were divided into 5 groups (n =10 each) using a random number table:sham operation group (group SH),conventional Ⅳ resuscitation group (group CVR),PR with normal saline group (group NS),PR with lactate-based PDS group (group LA) and PR with pyruvate-based PDS group (group PY).The animals only underwent surgical procedure in gronp SH.In group CVR,the animals were resuscitated with infusion of the blood withdrawn and normal saline (the volume was 2 times volume of blood loss) via the right femoral artery after successful establishment of hemorrhagic shock.In NS,LA and PY groups,conventional resuscitation was performed,and the animals were simultaneously resuscitated with normal saline,2.5％ glucose-based PDS containing lactate,and 2.5％ glucose-based PDS containing pyruvate 20 ml,respectively.The blood withdrawn and fluid for resuscitation were all infused over 30 min.MAP was recorded before blood letting,at 5,30 and 60 min of shock and at 5,30,60,90 and 120 min after the end of resuscitation.The arterial blood lactate level was measured by chemical colorimetry at 120 min after the end of resuscitation.The animals were then sacrificed and livers were removed for examination of the pathological changes with a light microscope.The damage to livers was assessed and scored.Results Compared with MAP before blood letting,MAP was significantly decreased during hemorrhagic shock and increased at each time point after resuscitation in CVR,NS,LA and PY groups (P＜0.05).Compared with group SH,MAP during hemorrhagic shock and at each time point after resuscitation was significantly decreased,and the arterial blood lactate level and liver damage scores were increased in CVR,NS,LA and PY groups (P＜0.05).Compared with CVR and NS groups,the arterial blood lactate level and liver damage scores were significantly decreased in LA and PY groups (P＜0.05).There was no significant difference in the arterial blood lactate level or liver damage scores between group CVR and group NS (P＞0.05).Compared with group LA,the arterial blood lactate level and liver damage scores were significantly decreased in group PY (P＜0.05).Conclusion PR with pyruvate-based PDS can reduce liver injury in a rat model of hemorrhagic shock.

In order to study the efficiency of small interfering RNA (siRNA) transfer mediated by cationic liposome, we used luciferase siRNA to evaluate the gene silencing activity in the Hep-2 cells, which were stably transduced with a luciferase gene. The pDNA transfection was studied, and siRNA arrearage assay was conducted to determine the capability of cationic liposome with siRNA. Different concentrations of siRNA was used to silence luciferase gene' activity, and then the result was examined by microplate reader. Cell viability was analyzed after transfection by MTT assay. The results suggested that Lipofectamine 2000 could transfer the pDNA efficiently, and have strong binding capacity with siRNA. The silencing efficiency of luciferase was obtained with low concentration of siRNA. The cell viability was influenced by RNA interference (RNAi) very slightly, but the cell survival rate decreased with the increase of siRNA concentrations. It was well concluded that by optimizing the experimental conditions, cationic liposome can transfer low concentration siRNA to silence target gene's activity efficiently.
Cations ; chemistry ; Drug Carriers ; Genetic Vectors ; Hep G2 Cells ; Humans ; Lipids ; chemistry ; Liposomes ; chemistry ; Luciferases ; genetics ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection