Objective To investigate the effect of continue nursing care post-discharge on the treatment effectiveness of gastric ulcer in active phase, and to facilitate the nursing quality. Methods A total of 163 patients with gastric ulcer were divided into control group including 80 cases and observation group including 83 cases randomly by hospitalization order. Routine nursing care was administrated on the two groups of patient's duration of hospital stay equally, but continue nursing care was administrated on the observation group patients exceptionally. The treatment outcome and intervention effect of the two groups were compared at the end of study. Results The overall cure rates of the control the observation group patients were 63.75%(30/80) and 81.93%(68/83), the eradication rates of helicobacter pylori (Hp) were 86.25%(69/80) and 96.39%(80/83), the medication compliance scores of Morisky were 3.69 ± 1.34 and 6.71 ± 1.57, the quality scores of life instruments for chronic were 67.81 ± 7.10 and 86.34 ± 6.83 respectively at the end of follow-up period. There were significant differences in the above indicators (χ2=6.830,5.330,t=13.199,16.977,P<0.05 or 0.01). Kaplan-Meier analysis showed that the cure period of the observation group was significantly shorter than that of the control group (χ2=20.446,P<0.05). Conclusions The continue nursing care post-discharge has positive effect on the treatment of active gastric ulcer, and it should be recommended in clinical application.

Objective To measure the expression of granulocyte colony-stimulating factor receptor (G-CSFR) in human melanocytes and to evaluate the biologic effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on human melanocytes.Methods Melanocytes were obtained from circumcision specimens of healthy males,and neutrophils were isolated from heparin-andcoagulated peripheral blood of healthy human followed by a primary culture.Then,the melanocytes in third passage were cultured with or without the presence of various concentrations (200,400,600,800 μg/L) of rhG-CSF for 72 hours.The growth and morphology of melanocytes were observed.Flow cytometry was performed to detect the expression of G-CSFR in untreated human melanocytes,neutrophils and erythroleukemia cells (HEL 92.1.7).Western blot and reverse transcription PCR (RT-PCR) were carried out to measure the expression of G-CSFR protein and mRNA respectively in the neutrophils,HEL 92.1.7 cells,treated or untreated human melanocytes.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferation,and dopa-oxidation assay to estimate the tyrosinase activity,of treated melanocytes.Results The expression rate of G-CSFR was 76.81％ ± 10.70％ in human melanocytes,significantly higher than that in the HEL 92.1.7 cells (2.53％ ± 1.54％,P ＜ 0.01 ),but lower than that in the neutrophils (85.76％ ± 15.71％,P ＜ 0.05).Both G-CSFR protein and mRNA were expressed in melanocytes,and there was no significant differences in the expression level of G-CSFR protein and mRNA among melanocytes treated with different concentrations of rhG-CSF (both P ＞ 0.05).The expression levels of G-CSFR protein and mRNA in the melanecytes were significantly higher than those in the HEL 92.1.7 cells (both P ＜ 0.01 ),but lower than those in the neutrophils (P ＜ 0.05 or ＜ 0.01 ).rhG-CSF at 200-800 μg/L displayed a significantly promotive effect on the proliferation of melanocytes (P ＜ 0.01 or ＜ 0.05 ),and the effect was in a dose-dependent manner when rhG-CSF ranged from 200 to 600 μg/L (P ＜ 0.01 ).The rhG-CSF at 600 μg/L and 12-O-tetradecanoyl-phorbol-13-acetate (TPA) at 20 μg/L showed an equivalent effect on the proliferation of melanocytes (164.04％ ± 13.0％ vs.165.62％ ± 10.6％,P ＞ 0.05).However,rhG-CSF from 200 to 800 μg/L had no significant impact on the tyrosinase activity of melanocytes (all P ＞ 0.05 ).Conclusions G-CSFR is expressed in human melanocytes. rhG-CSF can promote the proliferation of cultured human melanocytes,but has no obvious influence on the tyrosinase activity of melanocytes.

OBJECTIVE To investigate the restrained factors in the disposal of medical dispute caused by nosocomial infection and try to find out the method to solve the problem. METHODS The several restrained factors in the disposal of medical dispute about nosocomial infection were enumerated and analyzed. RESULTS There are several restrained factors in the disposal of medical dispute about nosocomial infection according to law. First, nosocomial infection can not be died out, and medical dispute about nosocomial infection will exist for ever as a result of the specialty of supply of medical service. Secondly, current legal system construction of nosocomial infection management in our country is in the stage of being established and consummated step by step. Determinant criteria of medical negligence behavior are not perfect. Feasibility of part of the actual rules and standard in nosocomial infection is not good. Thirdly, collecting evidence is very difficult in some medical dispute caused by nosocomial infection . It is restricted by hospital condition, medical cost and medical documents. Because of the restrained factors mentioned above, when nosocomial infection occurs, medical workers concerned can not find or confirm the reason of infection in most cases. Then hospital has to compensate patients for loss in order to make concessions to avoid trouble. CONCLUSIONS We make following suggestions for the status. First, we should strengthen legal system construction about nosocomial infection, and safeguard both of hospital and patients′ interests . Secondly, insurance system of medical risk should be perfected. Thirdly, medical workers should abide by rules of operation. Fourthly, we can not hide the truth when nosocomial infection occurs. Fifthly, we must fulfil the "attention duty" in order to reduce medical dispute.

Objective:To determine the valproate concentration in plasma of epilepsy patients by HPLC, and compare with the re-sults of chemiluminescence microparticle immunoassay ( CMIA) to evaluate the consistency of the two methods. Methods:HPLC and CMIA was respectively applied to determine the plasma concentration of valproate in 230 epileptic patients. The correlation of the two methods was studied by Passing-Bablok regression and Bland-Altman method. Results:The regression equation of the determination re-sults of HPLC (Y) and CMIA (X) was Y=1. 069 7X+2. 338 2 (R2 =0. 969, n=230), which showed promising correlation. Bland-Altman analysis showed that the consistency of the two methods was poor, and the values of HPLC were higher. Conclusion: HPLC and CMIA used for the determination of valproate plasma concentration show good correlation. However, the consistency is poor and there is system error. In the clinical treatment, adjustment and choice should be paid more attention.

Objective: To evaluate the genetic toxicity of Thuja essential oil by salmonella reversion test (AMES test) and mammal micronucleus test.Methods: TA97, TA98, TA100 and TA102 were used in AMES test to evaluate the mutagenesis of Thuja essential oil.Mouse bone marrow micronucleus test was conducted to assess the chromosome toxicity of the drug.Results: Both in S9 present and absent situations, the numbers of reverse mutation of Thuja essential oil at different doses for the four strains were all less than 1-fold of that of solvent control, and the difference had no statistical significance (P>0.05), suggesting negative mutation.The micronucleus test indicated that Thuja essential oil had no influence on the rate of mouse bone marrow micronucleus (P>0.05).Conclusion: Thuja essential oil shows no obvious genetic toxicity.

Objective:To evaluate the acute oral toxicity , skin irritation and skin allergy of Thuja essential oil ( TEO) , and pro-vide experimental basis for the clinical use of TEO .Methods:The acute oral toxicity was measured by Horn ’ s assay .Totally 40 KM mice were divided into four groups and intragastrically administered with TEO at different dose of 21.50, 10.00, 4.64 and 2.15 g · kg-1 .After the 14-day observation, the death number and toxic manifestations were recorded and observed , and LD50 was calculated by checking the Horn's form of LD50 .The skin irritation test was performed on healthy adult white rabbits .Totally 9 rabbits were divid-ed into 3 groups randomly , and TEO at the concentration of 100%, 50%and 25%was painted on the skin of the rabbits .Edible vege-table oil was used as the negative control .The erythema and edema of the treated skin were evaluated and scored .Delayed skin hyper-sensitivity reaction was used to investigate the allergy of TEO .Totally 30 white guinea pigs were randomly divided into 3 groups:TEO group, the negative control (edible vegetable oil) and the positive group (1%2, 4-dinitrochlorobenzene).After the intracutaneous in-duction stage and local induction stage , TEO was used to activate the hypersensitive reaction .The skin response was observed and scored after the 24-hour and 48-hour activation.Results:The mice in 21.50 g · kg-1 TEO treatment group were all dead , while only a part of the mice in 10.00 and 4.64 g · kg-1 TEO treatment groups were dead , and no mice died in 2.15 g · kg-1 TEO treatment group.According to the Horn's form of LD50 , LD50 of TEO was 9.26 g · kg -1 for male mice and 7.94 g · kg -1 for female mice.The results of skin irritation test indicated the strong irritation effects of TEO .However , the irritation of TEO was reduced after the dilution , and 25%TEO showed no irritation to the skin of rabbits .The results of delayed skin hypersensitivity reaction showed obvious erythema and edema induced by 2, 4-dinitrochlorobenzene , while no obvious erythema and edema were found in TEO treated guinea pigs , indi-cating non-allergic effect of TEO .Conclusion:TEO has strong skin irritation in rabbits , while no obvious oral toxicity in mice and skin allergy in guinea pigs .

Objective To explore the effects of folic acid and vitamin B12 supplement in maternal lactation on insulin resistance in fetal growth restriction (FGR) in rat offspring.Methods Eighteen Sprague-Dawley female rats and male rats were used.Pregnant rats were randomly divided into two groups at 12 days:normal-protein group (NP,n=6) and low-protein group (LP,n=12).The were 84 FGR newborn pups in LP group (93.3％,84/90).Forty-eight FGR newborn pups were randomly selected and divided into two groups (24 in each group):intervention group and non-intervention group.The intervention group was fed with high folate and vitamin B12 in the diet;and non-intervention group and NP group were fed normal diet.All of the newborn pups were weaned at 21 days after birth and then fed with normal diet.At days 21,60 and 120 d after birth,eight pups were randomly selected from each group and fasting plasma glucose (FPG),fasting insulin (FINS),blood diglyceride (TG) and cholesterol (TC) were measured.The insulin resistance index (IRI) and insulin sensitivity index (ISI) were calculated to evaluate insulin sensitivity.Variance and Student-Newman-Keuls tests were used for statistical analysis.Results (1) The incidence of FGR:Birth weight of LP offspring [(4.44±0.58) g] was significantly lower than that of NP ones [(7.03±0.56) g] (t=15.75,P ＜ 0.05).(2) FPG and FINS:at day 21 after birth,FPG of the non-intervention group,intervention group and NP group was (4.8±0.3),(4.8±0.4) and (4.6±0.3) mmol/L (F=0.57),respectively;FINS was (4.2± 0.2),(4.5 ±0.4) and (4.3 ±0.1) mU/L (F=0.31),respectively;and there was no significant difference among the three groups (both P ＞ 0.05).At day 60,FPG of the three groups was (7.5±0.4),(6.9± 1.0) and (5.5±0.6) mmol/L (F=17.14);FINS was (14.7± 1.9),(10.7± 1.0) and (9.2± 0.7) mU/L (F=38.34),respectively.At day 120,FPG was (8.9±0.9),(8.0±0.8) and (6.4±0.7) mmol/L (F=21.60);FINS was (56.3±2.8),(38.2±2.5) and (33.1 ±2.8) mU/L (F=164.46).FPG and FINS were highest in the non-intervention group,and lowest in NP group,with significant differences among the three groups of pups (all P ＜ 0.05).(3) IRI and ISI:at day 21,IRI of the non-intervention group,intervention group and the control group was 0.9±0.1,0.9±0.1 and 0.9±0.2 (F=0.49);ISI was-(3.0±0.7),-(3.0±0.1) and-(3.0±0.3) (F=0.69);and there was no significant difference among the three groups (both P ＞ 0.05).At day 60,IRI of the three groups was 4.9±0.8,3.3±0.3 and 2.2±0.3 (F=49.48);ISI was-(4.7±0.2),-(4.3±0.1) and-(3.9±0.1) (F=63.47).At day 120,IRI of the three groups was 22.4±3.1,13.6±2.0 and 9.3±0.9 (F=75.15);ISI was -(6.2 ± 0.1),-(5.7 ± 0.1) and-(5.3 ± 0.1) (F=104.42);and there were significant differences among the three groups (all P ＜ 0.05).(4) TC and TG:at day 21,TC of the non-intervention group,intervention group and the control group was (2.0±0.1),(2.0±0.1) and (2.0±0.1) mmol/L (F=0.10);TG was (0.75±0.1),(0.77±0.1) and (0.74±0.1) mmol/L (F=0.33);and there was no significant difference among the three groups (both P ＞ 0.05).At day 60,TC of the three groups was (2.3 ± 0.1),(2.2 ± 0.1) and (2.0± 0.2) mmol/L (F=8.34);TG was (1.5 ± 0.2),(1.2±0.1) and (1.0±0.2) mmol/L (F=17.93).At day 120,TC was (2.4±0.2),(2.2±0.1) and (2.1 ±0.1) mmol/L (F=6.12);TG was (1.7±0.5),(1.2±0.3) and (l.0±0.1) mmol/L (F=9.80).The TC and TG were highest in the non-intervention group and the lowest in the control group;and there were significant differences among the three groups (all P ＜ 0.05).Conclusion Supplementing folic acid and vitamin B12 in maternal lactation can improve in some extent insulin resistance in FGR rats,but not sufficient enough to completely repair glucose and lipid metabolism.

Objective To discuss the MRI findings of common complications following hip arthroplasty and their association with operative and pathological findings to improve the early diagnosis and etiological differential diagnosis for common complications following hip arthroplasty. Methods Forty-six patients with hip arthroplasty complication were included in this study. We observed prosthesis location, signal changes between prosthesis and bone, and periprosthesis signal changes, signal changes of articular capsule, adjacent soft tissue and bone on MR images. Diagnostic value of MRI in detecting hip arthroplasty complication was evaluated with operative and pathological findings as reference standard. Results Complications following hip arthroplasty included aseptic loosening (n=26), osteolysis (n=12), infection (n=12), heterotopic ossification (n=4), pseudoneoplasm (n=4) and periarthroplasty fracture (n=1). The MRI finding suggestive of aseptic loosening in 24 cases was a smooth intermediate signal intensity layer along the interface. Osteolysis is seen as soft tissue signal intensity material replacing normal high signal intensity fatty marrow in 12 cases. Bone marrow edema, bone destruction, fluid collection, estracapsular collections, periprosthetic muscle edema, and sinus were predictors of infection. On MRI, mature heterotopic ossification had the appearance of cancellous bone in 5 cases. Pseudoneoplasm represents fluid signal intensity with intermediate signal intensity pseudocapsule in 5 cases. Periprosthetic fracture included hypointesense fracture lines, periosteal reaction, and periprosthetic muscle edema in one patient. Conclusion MRI is useful in detecting osseous and soft-tissue abnormalities in patients with hip implants.

Objective To explore the effect of methylation of peroxisome proliferator-activated receptor γ(PPARy) gene promoter in liver and its mRNA expression changes on decreasing of insulin sensitivity in fetal growth restriction (FGR) rats.Methods Twenty pregnant rats were randomly divided into two groups on their first day of pregnancy:normal-protein group (NP) and low-protein group (LP),ten in each.During pregnancy the LP group rats were fed with low-protein diet (8.00％ protein),while the NP group rats were fed with normal-protein diet (20.00％ protein).The offspring rats were fed with standard feed after 21 days of birth.Male offsprings in NP group were as control offsprings,and male FGR offsprings in LP group ware as FGR offsprings.At day 3,7,14,30,60 and 90,fasting blood of offsprings was collected to measure fasting plasma glucose (FPG) and fasting insulin(FINS).Then insulin resistance index of homeostasis model assessment (HOMA-IR) and insulin sensitivity index (ISI) were calculated to evaluate insulin sensitivity.At day 7 and 90,liver tissue of male offsprings was collected to extract DNA and total RNA.The methylation level of PPARγ gene promoter and its mRNA expression were detected by methylation specific-polymerase chain reaction (MS-PCR) and reverse transcription-RCR,respectively.The relationships between methylation of PPARγ gene promoter and mRNA expression and insulin sensitivity were analyzed by Pearson correlation and nonparametric test method.Results (1) The mean offspring birth-weight of LP group was (4.92±0.36) g,which was lower than that [(6.43±0.59) g] of control group (t=14.73,P＜0.05).In LP group,the incidence of FGR offspring was 88.2％ (97/110) and the FGR incidence of male ones was 94.1％ (48/51).(2) At day 90,compared with control offsprings,FPG [(8.95±1.83) mmol/L vs (6.21±1.14) mmol/L,t=-3.291,P＜0.05],FINS [(59.57±9.89) mU/Lvs (36.10±7.32) mU/L,t=-4.916,P＜0.05] and HOMA-IR (0.967±0.297 vs 0.410±0.135,t=-4.472,P＜0.05) of FGR offsprings were significantly higher; while ISI of FGR offspring was lower than that of control offsprings (-3.043±0.294 vs -2.172±0.354,t=4.774,P＜0.05).(3) There was no significant difference in methylation degree of PPARγ gene promoter in liver between FGR and control offsprings at day 7 (0/8 vs 2/8,Fisher exact test,P＞0.05).The methylation degree of PPARγ gene promoter in liver in FGR offsprings was significantly higher than that of control offsprings at day 90 (8/8 vs 2/8,Fisher exact test,P＜0.05).Compared with control offsprings,PPARγ gene mRNA expression level of FGR offsprings decreased significantly at day 90 (4.3.07±7.51 vs 146.72± 40.66,t=7.09,P＜0.05).mRNA expression of PPARγ gene was the lowest in exhaustive methylation offsprings (27.2± 1.6),and then in partial methylation ones (47.3±33.0),the highest in no methylation ones (144.6 ± 21.2) (P＜0.05).(4) The correlation analysis showed that PPARγ mRNA expression level negatively correlated to the level of FPG (r=-0.819),FINS (r=-0.906) and HOMA-IR (r=-0.860),P＜0.05 respectively; but positively correlated to ISI level (r=0.947,P＜0.05).Conclusions Hypermethylation in promoter region of PPARγ gene might inhibit gene transcription,and be involved in the occurrence of insulin resistance in FGR rats.

Objective Compared with haloperidol treatment,naloxone and naloxone combined haloperidol treatments were assessed in their efficacy and safety for excited type delirium in elderly.Methods The elderly patients with delirium were divided into haloperidol treatment (H),naloxone treatment (N) and combined treatment (C) in a prospective randomized controlled design.Delirium score scale (DSS) was used before and after treatments respectively.Clinical global impression scale-severity of illness (CGI-SI) score was evaluated daily to assess the onset time and improvement of delirium.Agitation-calmness evaluation scale (ACES) observed calmness effect in agitated patients before and after every medication intervention.Treatment emergent symptom scale (TESS) assessed side effects of all medications.Results The duration of three groups(H(4.0 ±2.9)d,N(4.2± 3.5) d,C (3.2 ± 3.2) d) had no significant difference (P ＞ 0.05) by multiple comparison.Compared the onset time of three groups (H (2.4 ± 1.6) d,N (2.4 ± 1.4) d,C (1.3 ± 0.9) d),the combined group was faster than the other two groups (all P ＜ 0.05),no significant difference between the two groups(P ＞ 0.05).DSS scores had no significant differences (P＞ 0.05) in three groups before treatment,so did CGI-SI scores.In the end,DSS scores were(H:18.8 ± 11.5,N:27.7 ± 7.2,C:29.5 ± 5.6) respectively.Statistically naloxone group and combined group with no significant difference (P ＞ 0.05),were better than the haloperidol group (all P ＜ 0.01) in recovery.At the same time CGI-SI scores were (H:3.3 ± 1.5,N:2.5 ± 1.5,C:1.8 ± 0.9) respectively.Statistically combined group was better than the haloperidol group (P ＜ 0.01),and no significant difference with naloxone group (P ＞ 0.05).Three groups had no significant difference in ACES scores (P ＞ 0.05) before and after medication interventions(H:5.9 ± 1.6,N:6.2 ± 1.8,C:6.4 ± 1.6) (P ＞ 0.05).Haloperidol group had 4 cases of extrapyramidal symptom evaluated by TESS and combined group had 2 cases.Two groups had no significant difference (Chisquare test P ＞ 0.05) in extrapyramidal symptom incidence.The naloxone group showed no side effects.Conclusion Naloxone combined haloperidol is slight better than naloxone,more than haloperidol in terms of efficacy.Haloperidol equally with combined medication showed more side effects than naloxone.