Objective To discuss the nurses'satisfaction degree with work and its influencing factors and analyze the difference of nurses'satisfaction degree with work with different background.Methods 398 nurses in a certain comprehensive hospital were investigated with Mueller/McCloskey(MMSS)satisfactory inventory. Results The nurses'general satisfaction degree with work was less than middle level with a score of (3.12±0.46).The satisfaction degree was statistically different in different dimensionality and nurses with different background. Conclusion The management department of hospitals should adopt positive measures to improve the nurses'satisfaction degree with work and prompt them to supply more high-quality and effective nursing services.

In this study, the adsorption behavior of epirubicin hydrochloride (EPI) on carboxylated single-walled carbon nanotubes (c-SWNTs) obtained by mixture acid treatment was investigated. The results indicated that the dispersion of c-SWNTs in water was obviously improved. The absorption of EPI on c-SWNTs came to equilibrium after 240 min and could be explained by pseudo-second-order model. Moreover, there were heterogeneous distribution of active sites onto c-SWNTs surface and the Freundlich isotherm model was better fit to describe the absorption precess of EPI on c-SWNTs. The absorption capacity of EPI on c-SWNTs increased obviously with the increasing pH and decreasing temperature. Compared with multi-walled carbon nanotubes, carboxylated multi-walled carbon nanotubes, SWNTs, c-SWNTs possessed higher absorption capacity for EPI. The controlled, targeted and sustained release of EPI from c-SWNTs-EPI could be instructive for the development of nano-carrier.

Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.

Objective To observe the efficacy and safety of cetuximab chemotherapy combined with irinotecan in the treatment of advanced colorectal in the elderly.Methods 40 irinotecanresistant patients with K-Ras wild type were randomized to cetuximab weekly combined with irinotecan group (group A) and cetuximab biweekly combined with irinotecan group (group B).In group A,cetuximab was given at an initial dose of 400 mg/m2,followed by weekly 250 mg/m2.In group B,cetuximah and irinotecan were given at 500 mg/m2 and 180 mg/m2 respectively every two weeks.Time to progression (TTP),overall survival (OS) and toxicity were compared between the two groups.Results There were no significant differences in objective response rate (RR),disease control rate (DOC),TTP and OS between goup A and group B (30.0％ vs.25.0％,60.0％ vs.55.0％,5.8 months vs.5.6 months,9.8 months vs.9.5 months,respectively,all P＞0.05).Grade 3 or more toxicities including hematological toxicity,gastrointestinal reactions and skin toxicity were found in 2 cases,2 cases and 1 case respectively in group A and 3 cases,1 case and 2 cases respectively in group B.The two groups had no significant differences in toxicities (all P＞0.05).Conclusions Cetuximab combined with irinotecan therapy is effective in the treatment of advanced colorectal cancer in elderly irinotecan resistant patients.Cetuximab biweekly regimen is more convenient but has the same efficacy and toxicity as compared with cetuximab weekly regimen.

Objective Accumulating evidence has demonstrated that the sub-anesthetic dose of ketamine exerts rapid and ro-bust antidepressant-like effects though its action mechanisms are not yet fully understood .The aim of this study was to investigate the role of gamma-aminobutyric acid ( GABA) in the antidepressant effects of ketamine . Methods Thirty-two male Wistar rats were e-qually randomized into four groups: saline, ketamine, GABA, and GABA+ketamine.All the animals were implanted with a guide cannula into the lateral ventricle and on the eighth day after operation subjected to a 15 min forced swimming test (FST) for the estab-lishment of a depression model .At 24 h after modeling , the rats of the saline and ketamine groups were treated intracerebroventricularly with 2μL isotonic saline solution, and those of the GABA and GABA +ketamine groups with 50μg (2μL) GABA, followed by intrap-eritoneal administration of 1 mL saline in the former two groups and 10 mg/kg (1 mL) ketamine in the latter two groups 10 min later.At 30 min after treatment , the open field test ( OFT) was carried out for crossing and rearing scores and a 6-min FST was performed to re-cord the immobility time in the last 5 minutes.The content of GABA in the prefrontal cortex of the rats was measured following behav -ioral tests. Results The immobility time was significantly decreased in the ketamine group ([107.5 ±21.2]sec) as compared with the saline, GABA, and GABA+ketamine groups ([167.2 ±22.1], [159.8 ±17.5], and [143.8 ±22.1]sec) (P<0.05), with no significant difference between the GABA and GABA +ketamine groups (P>0.05).The level of GABA in the prefrontal cortex was remarkably lower in the ketamine group ([12.4 ±3.4]ng/mg prot) than in the saline, GABA, and GABA+ketamine groups ([23.3 ± 6.3], [27.3 ±5.7], and [18.0 ±5.4]ng/mg prot) (P<0.05), but markedly higher in the GABA than in the GABA +ketamine group (P<0.05).OFT scores exhibited no significant difference in the lo-comotor activity among the four groups of rats ( P >0.05 ). Conclusion The antidepressant effects of ketamine are related to the decreased GABA level in the prefrontal cortex in rats receiving FST .

Objective To compare the target dosimetric distribution and clinical outcome in patients with stage Ⅲ non-small cell lung cancer (NSCLC) treated with three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT).Methods The clinical data of 419 patients with stage Ⅲ NSCLC treated with either 3DCRT or IMRT were retrospectively analyzed.Among them,there were 338 male and 81 female patients,and the median age was 63 years (range:32-84 years).There were 340 patients treated with 3DCRT and 79 with IMRT,and the median prescribed dose was 60 Gy (range:50-76Gy).One hundred and forty patients were treated with radiotherapy alone and 279 were treated with chemoradiotherapy.The target dosimetric distribution was evaluated with dose-volume histogram (DVH)parameters.The overall survival (OS) rate was calculated using the Kaplan-Meier method and analyzed by the log-rank test.Results When comparing the clinical data,the patients treated with 3DCRT were in older ages,and had advanced N and clinical stages (P =0.01,0.00,and 0.00,respectively).When comparing the target DVH parameters,the patients treated with IMRT had larger planning target volume (PTV) (P =0.01),significantly lower clinical target volume (CTV) D CTV D90,PTV D and PTV V65-V60 (P =0.05-0.01),significantly higher V5-V20 in both lungs,higher esophagus D longer esophagus in the radiation field,higher linear energy transfer between 45 and 55 keV/μm (LET45-LET55),and higher spinal cord Dmean(P =0.03-0.00).The follow-up rate was 97.4％.After radiotherapy,the 1-,3-,and 5-year OS rates were 65.5％,26.1％,and 18.5％,respectively,and the median survival time was 20 months.There were no significant differences in OS rate and the incidence of acute radiation pneumonitis and radiation esophagitis between patients treated with IMRT and 3DCRT (P =0.06,0.73,0.13).Stratified analysis showed that,when comparing the patients treated with IMRT with those treated with 3DCRT,the survival rate was only lower in male patients,patients in stage T3-T4 or N0-N2,and those without chemotherapy (P =0.04,0.04,0.02,0.00).Conclusions The treatment outcomes of patients with stage Ⅲ NSCLC undergoing IMRT and 3DCRT are comparable.IMRT shows a potential dosimetric advantage,but the result needs further investigation.

All information processing and transmission in the brain involves synapses, the synaptic cell adhesion molecules play an important role in the formation, maturation and maintenance of synapses. Neuroligin1 ( NL1) is excitatory postsynaptic trans?membrane cell adhesion molecules. The interaction between NL1 and other molecules, such as Neurexin1 ( NRXN1) , involves in the formation, plasticity and function of synapses. NL1 knockout or overexpression displayed impairment in learning and memory, thus sug?gesting that NL1 participates in the pathophysiology of neuropsychiatric disease with cognitive dysfunction. Therefore, study of NL1 will open up new avenues to understand pathogenesis of cognitive dysfunction, and may provide a novel insight into prevention and treatment of cognitive dysfunction?associated diseases.

Objective To design a nursing checklist for continuous renal replacement therapy in ICU patients and to apply it to clinical settings. Methods A nursing checklist for continuous renal replacement therapy was de-signed through reviewing guidelines and literatures. The checklist was used in ICU patients treated with continu-ous renal replacement therapy,and nursing situation (including operation time,operation quality,etc.) was compared before and after application of the checklist. Results After applying the nursing checklist for continuous renal re-placement therapy,the nursing procedures were standardized,the operation time was reduced,and operation quality was improved. Conclusion The application of nursing checklist in nursing management of continuous renal replace-ment therapy helped to standardize continuous renal replacement therapy operating procedures,improve efficiency and quality at work,and ensure patient safety.

Objective To investigate the effect of penehychdine hydrochloride (PHCD)on acute lung injury induced by acute severe acute pancreatitis and the expression of hypoxia inducible factor-1α(HIF-1α)in rats.Methods Forty healthy adult male SD rats were used and randomly divided into 3 groups, group S of sham operation,group ALI of pancreatitis-associated acute lung injury (PALI)and group P of PALI with PHCD.Rats of group ALI and group P were the model established of acute lung injury associated with SAP by retrograde injection of 4% sodium taurocholate into biliopancreatic duct.Rats of group P of acute lung injury with SAP were immediately given PHCD after SAP.Rats of group S and group ALI were injected the same amount of 0.9% sodium chloride solution.After modeling,the rats were sacri-ficed at 12 h.The wet/dry weight ratio (W/D)of lung tissue was calculated.Pathological changes of pan-creatic and lung tissues were scored.HIF-1α,IL-1β,IL-6 of lung tissues and serum amylase were detected by ELISA.The expression of TLR4,NF-κB p65 in lung tissue was detected by Western blot.Results Ex-tensive infiltration of neutrophils,alveolar hemorrhage and necrosis and fat necrosis with pancreatic tissue were observed in group PALI and group P.Pancreatic tissue injury score was significantly higher than that of group S (P <0.01).However,there was no statistically significant difference between the level of serum amylase in group P and group ALI.The W/D ratio of lung tissue in rats of group ALI and group P was sig-nificantly higher than those in group S (P <0.05).Compared with those of group ALI,the lung tissue pathological changes of group P were significantly improved,and the lung W/D value was significantly lower than that of group ALI (P <0.05).Compared with group S,the expression of TLR4,NF-κB p65,HIF-1αin lung tissue of group ALI and group P was significantly higher (P <0.01),and the expression of TLR4, NF-κB p65,HIF-1α,IL-1βand IL-6 in group P was significantly lower than that in group ALI (P <0.05).Conclusion PHCD could not alleviate the damage of pancreatic tissue of SAP.It suppressed the expression of HIF-1α,IL-1βand IL-6 and reduced the acute lung injury induced by SAP in rats,which might be depen-ded on suppressing the expression of inflammatory factors,such as HIF-1α.

Objective To study the clinical features of hand-foot-mouth disease(HFMD) in neonates.Method From April 2015 to May 2016,the clinical manifestations,laboratory examinations,treatments and prognosis of neonates with HFMD in our hospital were retrospectively analyzed.Result A total of 6 cases of neonatal HFMD were included,with 4 males and 2 females.The ages of 2 patients were ≤7 days and the other 4 patients 8 ～ 28 days.5 patients developed this disease during April to July,while the other one in January.2 cases had a definite contract history of HFMD.4 cases presented with fever and rashes in hand and foot,one case with fever,rash and oral ulcer,and one case with rash in hip and oral ulcer without fever.The nucleic acid test of enterovirus were positive in 4 cases.The symptoms of these neonatal HFMD were mild and recovered after symptom-relieving treatment.Conclusion HFMD in neonates with fever and/or rash should be considered during the HFMD epidemic period.