Objective To evaluate the application effect of evidence-based nursing in reducing ventilator-associated pneumonia (VAP) of patients with severe head injury. Methods 100 patients with severe head injury using mechanical ventilation were randomly divided into the control group and the observation group with 50 patients in each group.The observation group explored evidence from nursing of ventilator tube,oropharyngeal and sound sects care,airway care,balloon sleeves care to prevent biofilm on the endotracheal tube(ETT-BF) to fall off,enteral nutrition care,decubitus care,ward environment and the hand disinfection of medical staff and was given evidence- based nursing.The control group took routine care.The incidence of VAP,off-line time and mortality rate of the two groups were compared during the same time period. Results The incidence of VAP,off-line time,mortality rate showed significant difference between the two groups.The observation group showed better effect. Conclusions Implementation of evidence-based nursing can significantly reduce the off-line time of patients with severe traumatic brain injury using mechanical ventilation.It can decrease the incidence of VAP and mortality rate,improve the prognosis and reduce medical cost.

Since several dengue viruses (DENV) have been isolated in Fujian Province during the past decade, sequencing and evolution analyses of viral envelope genes are helpful in determining their possible transmission origins. In this study, viral RNA was extracted from 12 DENV strains from Fujian between 20042010. Viral envelope genes were amplified, cloned into TA vectors and sequenced, and the sequence data were subsequently analyzed by bioinformatics software. Full-length E genes of DENV-1 or DENV-2 of 1 485 bp, and DENV- 3 of 1 479 bp were obtained. It was indicated, from BLAST analysis and phylogenetic trees, that DENV strains in Fujian Province during 20042010 shared the highest similarity with Southeast Asian strains, suggesting that DENV circulating in Fujian Province between 20042010 were probably imported from Southeast Asia. Hence, extensive monitoring on passengers from this region at the entry-ports should be strengthened.

Objective To analyze the clinical experience of applying PDCA management model in quality nursing ser-vice. Methods Chose 96 patients treated in our hospital to under analysis. They were assigned into observation group which received quality nursing measures under PDCA management model and control group which received conven-tional clinical nursing measures, with 48 patients in each group. Nursing quality, passing rate of equipment and drug operating, basic theory operating rate and nursing satisfaction of the two groups were compared. Results Before the im-plementation of the intervention, there were no obvious differences in critical illness nursing qualification rate, basic nursing qualification rate, nursing papers writing qualification rate, heath education awareness rate, and first aid items and equipment intact rate between the two groups (P>0.05﹚. After the implementation of the intervention, the clinical effect of observation group was obviously better than that before implementation of the intervention. And the clinical ef-fect of observation group was better than control group after the implementation of the intervention. The comparison was of statistical significance (P<0.05﹚. Nursing satisfaction of observation group was obviously better than that of control group, and there was statistical difference(P<0.05﹚. Conclusion Applying PDCA management model in quality nursing service during the nursing of patients has good effect. It can significantly improve clinical symptoms of patients and in-crease nursing satisfaction of patients.

OBJECTIVETo investigate the changes in local endometrial contents of estrogen receptors (ER) and progesterone receptors (PR) after insertion of levonorgestrel-releasing intrauterine system (LNG-IUS) and evaluate the efficacy of LNG-IUS in treating endometrial hyperplasia.

METHODSThe endometrial histological changes were observed in 25 anovulatory women with dysfunctional uterine bleeding after insertion of LNG-IUS, and the contents of ERs and PRs in the endometrium were measured by immunohistochemistry.

RESULTSThe endometrial proliferation activity was obviously inhibited 6 months after LNG-IUS insertion with decreased endometrial glands, glandular dysplasia and decidualization of interstitial cells. The positive cell rate for ERs and PRs in the glandular epithelial and interstitial cells were significantly reduced after LNG-IUS insertion.

CONCLUSIONSLNG-IUS can reduce ER and PR expressions in the endometrium and inhibit endometrial proliferation, and therefore can be effective in treating simple and complex endometrial hyperplasia.

Adult ; Endometrial Hyperplasia ; metabolism ; pathology ; Endometrium ; pathology ; Female ; Gene Expression Regulation ; drug effects ; Humans ; Intrauterine Devices, Medicated ; Levonorgestrel ; administration & dosage ; pharmacology ; Middle Aged ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism

OBJECTIVETo investigate the effect of RbAp48 knockdown on the migration and invasion of human cervical cancer cells and explore the mechanism.

METHODSA small interference RNA (siRNA) was used to knock down the expression of RbAp48 in MS751 cells. The changes in cell migration and invasion were evaluated using wound healing assay and Transwell assay, respectively, and the expressions of RbAp48, vimentin, N-cadherin, E-cadherin, Snail, Twist, MMP-2 and TIMP-2 were determined with Western blotting.

RESULTSAfter siRNA-mediated RbAp48 knockdown, MS751 cells showed a significantly reduced expression of RbAp48 with significantly suppressed cell migration and invasion (P<0.01). RbAp48 knockdown induced obvious down-regulation of the expressions of interstitial cell phenotype proteins vimentin, N-cadherin, and MMP-2 and up-regulation of epithelial cell phenotype proteins E-cadherin and TIMP-2, suggesting the inhibition of epithelial- mesenchymal transition of the cells. The expressions of Snail and Twist were significantly down-regulated in the cells following RbAp48 knockdown.

CONCLUSIONKnockdown of RbAp48 can significantly inhibit epithelial-mesenchymal transition and suppress the migration and invasion of cervical cancer cell line MS751, the mechanism of which may involve the down-regulation of Snail and Twist expressions.

Antigens, CD ; metabolism ; Cadherins ; metabolism ; Cell Line, Tumor ; Cell Movement ; Down-Regulation ; Epithelial-Mesenchymal Transition ; Female ; Gene Knockdown Techniques ; Humans ; Matrix Metalloproteinase 2 ; metabolism ; Neoplasm Invasiveness ; Nuclear Proteins ; metabolism ; RNA, Small Interfering ; Retinoblastoma-Binding Protein 4 ; genetics ; Snail Family Transcription Factors ; Tissue Inhibitor of Metalloproteinase-2 ; metabolism ; Transcription Factors ; metabolism ; Twist-Related Protein 1 ; metabolism ; Up-Regulation ; Uterine Cervical Neoplasms ; pathology ; Vimentin ; metabolism

Objective To investigate the characteristics of infectious occupational exposure among medical staff in newly-built hospitals, find out the high risk points of occupational exposure, and formulate occupational safety protection measures accordingly. Methods A retrospective survey in Beijing Tsinghua Changgung Hospital during January 2015 to October 2017 was carried out on occupation exposure, including gender, age, working years, occupation,exposure time, exposure sites, exposed sites and links, exposure to the source of infection and other aspects of the data, using SPSS 16.0 statistical analysis. Results There were 59 infectious occupational exposures. Among 59 infectious occupational exposures, 52 cases (88.1%) were sharp instrument injuries, 7 cases (11.9%) were blood and body fluid exposure. Occupational exposure occurred mainly in nurses (45 cases, 76.3%), followed by doctors (11 cases, 18.6%). The median age was 26 years, and the median length of work was 2 years. The location of exposure was mainly ward (26 cases, 44.1%), followed by operation room (17 cases, 28.8%). The location of sharp instrument injuries was mainly finger (44 cases, 84.6%). Sharps were mainly needles (38 cases, 73.1%), and the proportion of sharp instruments was 80.4%. The main causes of exposure were themselves (41 cases, 77.5%). Hepatitis B was the main pathogen of exposure (27 cases, 45.8%). No nosocomial infection was not found at follow-up. Conclusions New hospitals should establish a perfect occupational exposure management system, control the high-risk points, strengthen the occupational safety protection training, standardize the operation, and reduce the incidence of infection.

Objective　To investigate the clinical manifestations and diagnosis of the diseases with the imaging characteristics of pachymeningeal enhancement on magnetic resonance imaging （MRI），in order to improve the understanding of the diseases with pachymeningeal enhancement on MRI. Methods　The clinical data and auxiliary examination results of 5 patients with pachymeningeal enhancement on MRI from February 2017 to October 2019 were analyzed retrospectively，and the characteristics of each patient were analyzed. Results　MRI was similar in all five patients. All of them showed pachymeningeal enhancement，but the clinical diagnosis was different：1 case was idiopathic hypertrophic pachymeningitis；1 case was IgG4-related hypertrophic pachymeningitis；1 case was intracranial hypotension syndrome；1 case was cerebral venous sinus thrombosis；1 case was meningoma. Conclusions　The etiology，treatment and prognosis of diseases with pachymeningeal enhancement on MRI are complex，history and other auxiliary examination should be combined carefully to identify the diagnosis，avoiding misdiagnosis.