Objective To investigate the correlation between hope and medical coping styles among patients with diabetic foot ulcer.Method Fifty-four inpatients and outpatients with diabetic foot ulcer were investigated by the demographic questionnaire,the Herth hope index(HHI)and medical coping modes questionnaire(MCMQ)to investigate the status of their hope and coping styles and the correlation between them.Results The average score of hope was(36.50±5.06),which was at the high level.Confrontation was lower than the norm in coping styles(all P<0.05)and the differences between avoidance,acceptance-resignation and norm were not statistically significant(P>0.05).The average score on hope was positively correlated with confrontation but negatively correlated with avoidance(all P<0.05),and there was no significant correlation with acceptance-resignation(all P>0.05).Conclusions The hope of patients with diabetic foot is high.It is positively correlated with confrontation and negatively correlated with acceptance-resignation in coping styles.Nurses should instruct the patients to adopt positive coping styles,avoid negative coping styles and keep them at a higher level of hope.

Objective To analyze the characteristics of blood loss for laboratory test of critically ill premature infants,and to seek feasible measures to reduce the blood loss.Methods Two hundred and forty-six cases of critically ill premature infants admitted to the neonatal intensive care unit from April 2012 to April 2013 were analyzed the blood loss for test during the hospitalization and the clinical features of blood loss with different gestational age,different weight within the first four weeks after admission.Then the application of blood loss according to test category was described.The blood volume demanded in theory was determined by the formula B =5 (∑ s + 0.1),then calculated the phlebotomy overdraw on the basis of the practical blood loss and analyzed the characteristics of overdraw per patients per day in first two weeks after admission.Results Among 246 patients,The median blood loss figure was 25.57 ml for each infants with the range between 7.10 ml ～ 119.20 ml,and the blood loss concentrated in first four weeks,which showed a decreasing trend with time.There was a statistically significant difference(P ＜0.05)that the smaller gestational age,the lower birth weight,the more daily blood loss per patient per day in first two weeks,but no significant differences(P ＞ 0.05) between the third and fourth week.The largest proportion of the blood samples was used for clinical chemical tests(31.49％),followed by blood gas analysis (19.03％),immunoassays (12.69％),blood cultures (12.63％),hematology (12.28％).The practical blood loss was about twice times of blood volume demanded for tests in theory,which the median was 7.8 times to the latter(25.57 ml vs 3.26 ml).It showed statistically significant difference(P ＜0.05) between blood overdraw per patients per day in the first week and the second week.Compared with different gestational age and birth weight,the difference of overdraw was also statistically significant(P ＜0.05).According to test category,blood culture was the most significant samples of phlebotomy overdraw,followed by biochemical,other,blood gas analysis,the percentage was 76％,64％,45％ and 41％ respectively.Conclusion The blood loss for laboratory test and the phenomenon of blood waste is serious in critically ill preterm infants.The smaller the gestational age is,the lower the weight is,the amount of blood loss and phlebotomy overdraw are more significantly.Biochemical and blood gas analysis are the main items of blood loss.

Objective To make the management responsibility clear for guarding against the lacking of legal basis in patient lawsuits.Methods An implantable coding database for medical consumables was set.Barcode on packaging bag was scanned in 'information system'.'secondary management database for high-value consumables' was set in operation room.According to a warehouse-out list,the warehouse was checked monthly.Results The flow of all consumables was controlled.Conclusion Operational links are reduced and work efficiency is improved.Besides,the transparency of charges is increased.[Chinese Medical Equipment Journal,2008,29(2):64-65]

Objective To develop a humidification fluid dropping joint for the breathing machine to solve the problems in humidification fluid retension,pipeline leakage,pipeline fixation and etc.Methods A Infusion extension tube was involved in with 10 cm length left at the injector end.A hole was made at the side wall of the L-shaped joint of the breathing machine,whose internal diameter equaled to the external diameter of the extension tube.The extension tube was put into the joint through the hole,and the depth of imbedded tube was within 4 and 6 cm.Sealing and fixation at the connection between the tube and hole were executed with 502 glue and short tourniquet.Results The humidification fluid dropping joint could be connected with infusion apparatus of the pump or the infusion extension tube of the micro pump,which behaved well in eliminating accumulated humidification fluid,sputum suction,humidification and facilitating mechanical ventilation.Conclusion The joint developed gains advantages in easy manufacture,reducing complications and increasing the dependence on artificial airway,and thus is worthy promoting clinically.

To investigate the effects of particle size, mPEG molecular weight, coating density and zeta potential of monomethoxyl poly(ethylene glycol)-poly(lactic-co-glycolic acid) (mPEG-PLGA) nanoparticles on their transportation across the rat nasal mucosa, mPEG-PLGA-NPs with different mPEG molecular weights (M(r) 1 000, 2 000) and coating density (0, 5%, 10%, 15%) and chitosan coated PLGA-NP, which loaded coumarin-6 as fluorescent marker, were prepared with the nanoprecipitation method and emulsion-solvent evaporation method, and determine their particle size, zeta potential, the efficiency of fluorescent labeling, in vitro leakage rate and the stability with the lysozyme were determined. The effects of physical and chemical properties on the transmucosal transport of the fluorescent nanoparticles were investigated by confocal laser scanning microscopy (CLSM). The result showed that the size of nanoparticles prepared with nanoprecipitation method varied between 120 and 200 nm; the size of nanoparticles prepared with emulsion-solvent evaporation method varied between 420 and 450 nm. Nanoparticles dispersed uniformly; the zeta potential of PLGA-NPs was negative; mPEG-PLGA-NPs was close to neutral; chitosan coated PLGA-NPs was positive; and the efficiency of fluorescent labeling were higher than 80%. In vitro leak was less than 5% within 4 h and nanoparticles were basically stable with lysozyme. The CLSM results show that the transportation efficiency of mPEG-PLGA-NPs with a high PEG coating density and high mPEG molecular weight was significantly higher than that of uncoated PLGA nanoparticles and also that of chitosan coated PLGA-NPs (P < 0.05). The hydrophilcity, zeta potential and particle size of nanoparticles play important roles on the efficiency of mPEG-PLGA nanoparticles to transport across the rat nasal mucosa.

Objective To explore the correlation of empowerment with illness perception among inpatients with type 2 diabetes mellitus. Method The convenience sampling method was used to investigate the status of empowerment and illness perception among 102 patients with type 2 diabetes mellitus from October 2014 to July 2015, followed by analyzing the association between the two variables. Results The total score of empowerment was (4.00 ± 0.65), and the total score of illness perception was (38.00 ± 2 . 33 ) . The empowerment was positively correlated with illness perception ( P < 0 . 001 ) . The empowerment was positively correlated with the timeline, personal control, treatment control, illness concern and illness comprehensibility, respectively (all P<0.001). Conclusions The empowerment of patients with type 2 diabetes mellitus is at a high level, and positively correlated with illness perception, more pronounced chronic nature, the better personal control and treatment control, a higher degree of concern about the disease and better personal understanding of the illness contributed to a higher degree of empowerment. Medical staff should evaluate the illness perception of the patients with type 2 diabetes mellitus regularly in the daily work so as to improve the illness perception , improve their empowerment and promote the patients′quality of life eventually.

Objective To investigate the effect of nuclear translocation of E2p45 related factor 2 (Nrf2)on the biological activity of melanocytes.Methods Plasmid vectors containing wild-type nrf2 gene (pcDNA-nrf2) and nls-deleted nrf2 gene (pcDNA-nrf2△nls) were constructed.B10BR normal murine melanocytes were classified into three groups,i.e.,untransfected group,wild-type nrf2 group transfected with pcDNA-nrf2,and mutated nrf2 group transfected with pcDNA-nrf2△nls.Each of the above groups were further divided into three subgroups:control subgroup receiving no treatment,hydrogen peroxide (H2O2) subgroup treated with H2O2 of 200 μmol/L for 24 hours,and combined subgroup pretreated with tert-butyl hydroquinone (TBHQ) followed by treatment with H2O2 of 200 μmol/L for 24 hours.Subsequently,methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferative activity of cells,dopa oxidation assay to determine tyrosinase activity,Transwell assay to estimate cell migration ability,Western blot to quantify the expressions of Nrf2 and his tag fusion protein.Results TBHQ significantly enhanced the nuclear expression of Nrf2 in B10BR cells transfected with pcDNA-nrf2 or pcDNA-nrf2△nls (both P ＜ 0.01).No significant difference was observed in tyrosinase activity between untreated wild-type nrf2 group,mutated nrf2 group,and untransfected group (P ＞ 0.05).There was a statistical decrease in tyrosinase activity in the two H2O2-treated transfected groups compared with the untreated transfected groups (both P ＜ 0.05),and the decrease was reversed by TBHQ pretreatment in the wildtype nrf2 group (P ＜ 0.05),but not in the mutated nrf2 group (P ＞ 0.05).Further more,the proliferative activity of B10BR cells experienced no obvious changes in the wild-type nrf2 group (P ＞ 0.05),but was significantly reduced in the untransfected group (P ＜ 0.05) and mutated nrf2 group (P ＜ 0.01) after the H2O2 treatment compared with the corresponding untreated groups.TBHQ could protect the pcDNA-nrf2-transfected B10BR cells,but not pcDNA-nrf2△nls-transfected B10BR cells,from H2O2-induced oxidative damage.Transwell assay showed no significant difference in migration ability among these nine groups (P ＞ 0.05).Conclusions Abnormal nuclear translocation of Nrf2 could affect antioxidant activity of,proliferative activity of and tyrosinase activity in melanocytes.TBHQ may enhance the tyrosinase activity in,proliferative activity and antioxidant activity of melanocytes via activating the nuclear expression of wild type Nrf2.

Objective To explore the HLA-A2 restriction and immunogenicity of 5 previously identified HCV-speeific CTL epitopes. Methods Based on T2 cell, to explore the HLA-A2 restriction of previously identified HCV-specific CTL epitopes by MHC-peptide complex stabilization assay;To detect pep-tide-specific CTL in HLA-A2~+ PBMC stimulated by HLA-A2-restricted peptides by intracellular cytokine staining(ICS) and ELISPOT; To explore the cytotoxicity of peptide-specific CTL to same peptide-loaded T2 cells (target cells) by CTL cytotoxicity test. Results Among 5 previously identified CTL epitopes NS4b_78 (SMMAFSAAL) and NS5a_367 (TVSSALAEL) have high-affinity for HLA-A2 molecules(FI 1) ;ELISPOT results shown that NS4b_78(SMMAFSAAL) and NSSa_367(TVSSALAEL) induced high levels of IFN-γ-se-creting cells [(60±6) SFC/10~4 PBMC vs (4±1 ) SFC/10~4 PBMC, P < 0.01 ; (10 ± 3 ) SFC/10~4 PBMC vs (2±1 ) SFC/10~4 PBMC, P <0.01, respectively] ;ICS results indicated that there were high percentages of CD8~+ IFN-γ~+ T cells in total CD8~+T cells stimulated by these peptides [(2.33 ±0.22 ) % vs (0.05±0.01)%, P <0.001 ; (0.36±0.06)% vs (0.03±0.01)%, P <0.001, respectively]. Furthermore,peptide-specific CTL could effectively kill same peptide-loadcd T2 cells. Conclusion NS4b_78 (SMMAF-SAAL) and NSSa_367 (TVSSALAEL) were identified as HLA-A2-restricted CTL epitopes which could in-duce immune response in vitro.

Objective To study on the specific cellular immune response produced in BALB/c mice immunized with human papillomavirus (HPV) type 6b capsid protein L1 and Chlamydia trachomatis (Ct) major outer membrane protein(MOMP) multi-epitope chimeric DNA (HPV6b L1/Ct MOMP multiepitope) , and the enhancement of the specific cellular immune response to Ct MOMP multi-epitope by HPV6b L1. Methods The Ct MOMP multi-epitope gene was connected to the C terminal of HPV6b L1,the gene of HPV6b L1 had been optimized according to the codon usage of eukaryotic system, and then the HPV6b L1/Ct MOMP multi-epitope chimeric gene was cloned to pcDNA3.1 ( + ) vector. After identification by restriction enzyme digestion and DNA sequencing, the recombinant plasmid was transfected into COS-7 cells, Indirect Immunofluorescence (IIF) was used to confirm the expression of proteins. Then, BALB/c mice were randomly assigned to receive (intramuscular injection) either pcDNA3.1 ( + )/HPV6b L1/Ct MOMP or pcDNA3.1 ( + )/Ct MOMP or pcDNA3.1 ( + ) or PBS ( n = 12, 150 μg/time), and the same immunization schedule was repeated third times at 2 week intervals. The level of cytokine( IFN-γ, IL-4, IL-10) -producing CD3+ T cells in spleen, the cytotoxicity of Ct MOMP-specific and HPV6b L1-specific cytotoxic T lymphocyte (CTL) in spleen were detected by intracellular cytokine staining-fluorescence activated cell sorter (ICS-FACS) and LDH release assays, respectively. Results After immunization, when the efCTL (44.56%±4.02%, 35.35% ±2.89% ) and HPV6b L1 specific cytotoxicity of CTL (27.08% ±2.04%, 21.68% ±4.06% ) in pcDNA3.1 ( + )/HPV6b L1/Ct MOMP multi-epitope chimeric DNA immunized mice, were significantly higher than that in pcDNA3.1 ( + )/Ct MOMP multi-epitope DNA (35.50%±2.68%, 30.24% ±1.75%; 12.27% ±3.36%, 9.32% ±3.07%) and other control groups(F=72.87, F=114.55, P＜0.05; F=30.04, F=10.47, P＜0.05), and Ct MOMP multi-epitope specific cytotoxicity of CTL in pcDNA3.1 ( + )/Ct MOMP multi-epitope DNA immunized mice were significantly higher than that in control groups( F = 58.85, F = 120.21; P<0.05). The level of intracellular cytokine IFN-γ in pcDNA3.1 ( + )/HPV6b L1/Ct MOMP multi-epitope DNA immunized mice(4.34% ±0.06%)was higher significantly than that in pcDNA3.1 ( + )/Ct MOMP multi-epitope DNA immunized mice(3.14% ± 0.18%, P<0.05 ) and other control groups ( F = 473.83, P<0.05 ), while, the levels of IL-4 ( F =0.97, P ＞ 0.05 ) and IL-10 ( F = 2.25, P ＞ 0.05 ) had no significant difference between groups. Conclusion Both Ct MOMP and HPV6b L1 protein specific cellular immune response could be induced in BALB/c mice immunized with HPV6b L1/Ct MOMP multi-epitope chimeric plasmid, and the HPV6b L1 gene optimized by eukaryotic codon could significantly enhance the cellular immune response induced by Ct MOMP multi-epitope gene in BALB/c mice.

Objective To express and purify the epitope peptide of human melanin-concentrating hormone receptor 1, and to evaluate its performance in the detection of autoantibodies in vitiligo patients. Methods The target gene encoding the epitope peptide of human melanin-concentrating hormone receptor 1 was synthesized, cloned to prokaryotic expression vector pGEX-4T-2 which was then transferred to E. coli BL21. The protein expression was induced by isopropy-β-D-thiogalactoside (IPTG) and identified with sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot. Blocking ELISA was carried out with membrane proteins extracted from melanocytes as the blocking antigen. The antigenicity of the peptide was detected in sera from 100 patients with progressive vitiligo and 30 healthy human controls. Results The recombinant expression vector was successfully constructed, and the target protein was successfully expressed in E.coli, which was evidenced by SDS-PAGE and Western blot. With the glutathione S-transferase (GST) purification kit, the purity of the recombinant protein reached 100% when the sampling weight was less than 0.625 μg.The binding of the target protein with serum IgG antibodies from vitiligo patients could be blocked by natural membrane antigen of melanocytes. Of the 100 sera from patients with progressive vitiligo, 36 were reactive with the target protein. Conclusions The epitope peptide of human melanin-concentrating hormone receptor 1 has been successfully expressed and purified. The purified protein can bind with serum IgG antibodies from vitiligo patients, and may be applied to the detection of autoantibodies against human melanin-concentrating hormone receptor 1.