Objective To Establish an evaluation index system of critical care nurses training in Chongqing. Methods A panel of experts was formed with 20 experts from related fields. By the use of Del-phi method, we designed a questionnaire survey and took two rounds of expert consultation and revision, screening the intensive care nurse training evaluation index. SPSS 17.0 statistical software was used to assess the experts involved in the study and to determine the weight of indicators at all levels. Results In the course of the investigation, the experts participating in the initiative was very high, and the authority coeffi-cient (Cr) was 0.896. The training evaluation system of critical care nurses in Chongqing was initially iden-tified, including 3 first-level indicators, 7 second-level indicators 7, 21 third-level indicators. Conclusion The preliminary construction of critical care nurse training evaluation system in Chongqing can promote the ICU specialist nurse training effect and guarantee the training quality, and at the same time it provides some reference for the training and evaluation of the health administrative department.

This paper is based on conflicting issues in clinical teaching between undergraduates and residents, also around cultivating goals on clinical competency. In order to enhance medicine-education collaboration and conception of continue education and improve clinical teaching management system for integration of undergraduates and residents, five measures should be put into practice. First, define the re-sponsibility of physicians at all levels. Then, accord training standards for clinical teachers' admission. Next, accord clinical teaching norms and documents. In addition, clinical teaching assistants are selected from intermediate physician for guiding clinical teachers. Finally, explore the integration of clinical teaching mood for training between undergraduates and residents, to promote the connection of clinical teaching for graduates and residents.

AlM:To explore the effective method for the treatment of complicated ocular trauma accompanied with cyclodialysis.METHODS: Sixty - eight cases of complexity ocular trauma with cyclodialysis in different degrees were undergone vitrectomy and ( or ) combined with ciliary body reduction.RESULTS:All patients were followed up for 10 ~36mo (mean 17. 0±5. 7mo). The postoperative visual acuity was better than that of preoperation (P<0. 05). Compared with preoperative, intraocular pressure was significantly increased ( P < 0. 05 ). Successful rate of ciliary body restoration was 91%. CONCLUSlON: For the complicated ocular trauma accompaniedwith cyclodialysis, vitrectomy and ( or ) ciliary body reduction is an effective treatment method.

Objective To observe the prevalence of hyperuricemia(HUA)among obese children,and to ex-plore the association between uric acid(UA)levels and cardiometabolic risk factors,acanthosis nigricans and non - al-cohol fatty liver disease(NAFLD). Methods By using representative sampling method,1 753 obese children aged 6 -17 years old from 18 schools in 3 districts of Beijing(Xicheng,Haidian,Miyun)were selected to participate in the clini-cal examinations,including anthropometric measurements(height,weight)and blood pressure. Serum biochemical pa-rameters were assessed,including fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high - densi-ty lipoprotein cholesterol(HDL - C),low - density lipoprotein cholesterol(LDL - C)and UA. Acanthosis nigricans and B - model ultrasonography of the liver were conducted. Results The prevalence of hypertension,impaired fasting glu-cose,dyslipidemia,acanthosis nigricans,and NAFLD among these 1 753 obese children was 33. 6%(589 cases), 66. 5%(1 156 cases),54. 3%(943 cases),23. 3%(408 cases),and 17. 0%(298 cases),respectively. The preva-lence of HUA was 40. 70%(714 / 1 753 cases),with 50. 17%(581 / 1 158 cases)in boys and 22. 34%(133 / 595 ca-ses)in girls. There was a significant increase in body mass index,systolic blood pressure,diastolic blood pressure, FPG,TG and LDL - C with the increase of UA,but there was a decrease in HLD - C with the increase of UA(all P ﹤0. 05). In boys,the adjusted odds ratios( OR)and 95% CI of the highest quartile of UA for hypertension,impaired fasting glucose,dyslipidemia,acanthosis nigricans,and NAFLD were 1. 16(0. 77 - 1. 74),1. 34(0. 90 - 1. 99),1. 29 (0. 89 - 1. 87),1. 89(1. 17 - 3. 04),and 1. 71(1. 03 - 2. 84),respectively;in girls,the adjusted OR and 95% CI of the highest quartile of UA for hypertension,impaired fas-ting glucose,dyslipidemia,acanthosis nigricans,and NAFLD was 0. 70(0. 40 - 1. 24),0. 60(0. 40 - 1. 00),1. 69(1. 04 - 2. 70),1. 67(0. 80 - 3. 49),and 1. 33(0. 48 - 3. 66),re-spectively. Conclusions The prevalence of HUA is relatively high in obese children and there is a strong association between UA and some car-diovascular metabolic disorders,acanthosis nigricans and NAFLD.

OBJECTIVETo evaluate the safety and therapeutic effect of high-dose daunorubicin-based (HD-DNR) chemotherapy in the treatment of acute leukemia (AL).

METHODSThe clinical data of 25 AL patients, including 14 cases for induction chemotherapy, 8 for consolidation chemotherapy and 3 for reinduction therapy, which were treated with HD- DNR (DNR dosage of 90 mg/m(2)× 3 d) between June 2010 and August 2012 in our hospital were retrospectively analyzed, the adverse reaction of chemotherapy, especially cardiac toxicity and therapeutic effect were evaluated.

RESULTSMost of the adverse reactions were mild, including cardiac toxicity, and no patient discontinued therapy because of HD-DNR related toxicities. Grade 3 or higher adverse reactions occurred only in the infection (56%) and diarrhea (12%). Withdrawal or dose reduction due to strong adverse reactions was not observed in all patients. Adverse reactions of infections (92%), lower ejection fraction(52.6%), diarrhea (48%), nausea (36%), vomiting (36%), dental ulcer (36%) and myocardial ischemia (32%) were relatively more common. The median time of neutrophil count reached to ≥ 0.5 × 10(9)/L and platelet ≥ 20 × 10(9)/L were both 21 days(ranged 9-31 and 9-38 days). Nine patients were complicated with infections before chemotherapy and 14 after chemotherapy, mainly occurred in gastrointestinal tract and respiratory system. Gastrointestinal, liver and kidney toxicity was slight. The cardiac ejection decreased in 10 cases, but only 1 reached grade 2 without clinical symptoms. Of the 14 AL patients for induction chemotherapy, 13 achieved hematological complete remission. Eight patients received HD-DNR as consolidation chemotherapy remained complete remission, while 3 refractory/relapsed patients remained non-remission.

CONCLUSIONThe adverse reaction of HD-DNR based chemotherapy for AL treatment was mild, no obvious cardiac adverse reaction occurred. The treatment dose of DNR at 90 mg/m(2) × 3 d can be safely and effectively used to treat acute leukemia.

Acute Disease ; Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; adverse effects ; therapeutic use ; Daunorubicin ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Humans ; Leukemia ; drug therapy ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Posttranslational modifications of antibody products affect their stability,charge distribution,and drug activity and are thus a critical quality attribute.The comprehensive mapping of antibody modifications and different charge isomers(CIs)is of utmost importance,but is challenging.We intended to quanti-tatively characterize the posttranslational modification status of CIs of antibody drugs and explore the impact of posttranslational modifications on charge heterogeneity.The CIs of antibodies were fraction-ated by strong cation exchange chromatography and verified by capillary isoelectric focusing-whole column imaging detection,followed by stepwise structural characterization at three levels.First,the differences between CIs were explored at the intact protein level using a top-down mass spectrometry approach;this showed differences in glycoforms and deamidation status.Second,at the peptide level,common modifications of oxidation,deamidation,and glycosylation were identified.Peptide mapping showed nonuniform deamidation and glycoform distribution among CIs.In total,10 N-glycoforms were detected by peptide mapping.Finally,an in-depth analysis of glycan variants of CIs was performed through the detection of enriched glycopeptides.Qualitative and quantitative analyses demonstrated the dynamics of 24 N-glycoforms.The results revealed that sialic acid modification is a critical factor ac-counting for charge heterogeneity,which is otherwise missed in peptide mapping and intact molecular weight analyses.This study demonstrated the importance of the comprehensive analyses of antibody CIs and provides a reference method for the quality control of biopharmaceutical analysis.

ObjectiveTo investigate the living condition of patients with spinal cord injury (SCI) after Tangshan earthquake.MethodsA questionnaire was designed for the investigation with 41 items including resident environment, income, mood, etc. The faculty of surveillance was composed of trained professionals. 1261 SCI patients living in Tangshan at present, 420 of which live in the sanatoriums and others live in the common families. The patients of four sanatoriums were chosen randomly from fourteen sanatoriums to be investigated in detail, and patients in the common families in two communities, one from city, another from countryside, were also chosen. This investigation was performed in 2003.The results are compared with that of 1988' survey.ResultsGreat improvements in the living condition of SCI patients in Tangshan were shown by the comparison of these two surveys, they were mainly in: the progress in the housing environments (100% SCI patients now live in the specially designed reconstructed houses); better medical services provided (the ratio of wheelchair available from 38.1% to 100%); the majority of the patients in acceptance stage of their disability; the increase of income (21.1% takes up various occupation) with a vigorous spare time; decrease in the common complications with SCI patients; although uremia was still the first death cause of the SCI patients, the percentage was decreased apparently; cardiovascular accident had a higher percentage in the death cause(the second leading cause), implies that the death cause of the SCI survivors had approached the normal person.ConclusionThe improvements reflect the social progress in China. However, still there are some problems to be remained for further solution: the ratio of employment is low; the insurance of living and medical rehabilitation needs further improvement.

OBJECTIVETo investigate the prevalence of influenza virus infections in children in 2006 using the real-time PCR method.

METHODS(1) Consulting the most conserved sequence NP gene of influenza virus, after comparing with the NP gene sequences of influenza virus in GenBank, one pair of specific primers and one TaqMan probe were designed for each subtype of influenza virus by the software Primer Express. The sensitivity of influenza was evaluated by testing known positive samples which had been two-fold diluted. The specificity of real-time PCR for influenza virus detection was assessed by cross testing 60 isolates of influenza A, 16 isolates of influenza B, and by testing a variety of other respiratory viruses positive samples; (2) 281 nasopharyngeal aspirate samples were detected by real-time PCR and virus isolation; (3) the 12 301 specimens from the patients of Guangzhou Children's Hospital were tested by using the real-time PCR method. Furthermore, the real-time PCR reagent was evaluated by comparing with the result of virus isolation.

RESULTS(1) The sensitivity of real-time PCR developed in this study for influenza A detection was 1:2(22) and for influenza B was 1:2(20) in two-fold serially diluted way. (2) No positive results were found in cross testing of other viruses positive specimens. (3) Influenza virus was detected from 1687 cases (13.71%) out of the 12 301 cases, including 773 cases (45.8%) positive for subtype A and 914 cases (54.2%) positive for subtype B; 455 out of 525 (86.7%) of influenza B positive specimens and 70 out of 525 (13.3%) of influenza A (H1N1) positive specimens were from patients seen during January to April; 419 out of 1118 (37.5%) specimens positive for influenza B and 699 out of 1118 (62.5%) specimens positive for influenza A (H1N1) were from patients seen from May to August. Influenza virus could be identified from 1380 samples by the methods of virus isolation, accounting for 81.80% of the 1687 positive samples detected by real-time PCR. All the influenza virus subtype A was H1N1.

CONCLUSIONThe real-time PCR method developed in this study was sensitive and specific for detecting influenza A and B in clinical specimens. During 2006, influenza A and influenza B co-circulated. The predominant virus was influenza B from January to April, peaking in April. Influenza A (H1N1) prevailed from May to August, with the peak in June.

Child ; China ; epidemiology ; Epidemics ; Humans ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza, Human ; epidemiology ; virology ; Polymerase Chain Reaction ; methods ; Prevalence ; RNA, Viral ; isolation & purification ; Sensitivity and Specificity

OBJECTIVETo determine the prevalence of nonalcoholic fatty liver disease (NAFLD) and metabolic abnormalities in obese children and adolescents in Beijing.

METHODSThis study involved 387 obese children and adolescents, aged 12 to 17 years in Beijing. Data on anthropometric measurements was collected, including weight, height and age. All subjects underwent a clinic examination containing fasting blood and liver ultrasonography. Nonalcoholic fatty liver disease was diagnosed using diagnostic criteria for nonalcoholic fatty liver disease which was recommended by the Fatty liver and Alcoholic Liver Disease Study Group of Liver Disease Association in China.

RESULTS174 out of the 387 children were diagnosed as having NAFLD. The overall prevalence of NAFLD was 45.0% in this study population. The prevalence rates of NAFLD did not show significant difference between girls and boys. The prevalence rates of diabetes mellitus and IFG were 0.8% and 49.1% respectively. The prevalence rates of HTG, HTC, HLDL-C, LHDL-C, IFG, elevated ALT (or AST) and acanthosis nigricans were 6.3%, 4.0%, 37.9%, 22.8%, 46.0%, 17.8% and 28.5% in students combined with obesity and NAFLD, respectively. In the NAFLD subgroup, higher prevalence of high TG, acanthosis nigricans, abnormal ALT or AST were seen. With the increasing of obesity, the level of LDL-C, TG, liver function disturbance and prevalence of NAFLD and acanthosis nigricans were aggravated. Under binary logistic regression analysis, results showed that high BMI, acanthosis nigricans and TG were significantly correlated with NAFLD in obese children and adolescent population.

CONCLUSIONNAFLD was common in obese children, and the prevalence of NAFLD in obese children was 45.0%. Higher BMI, acanthosis nigricans and abnormal TG were independent risk factors for NAFLD in obese children. Obese children who had been exposed to high risk factors should take the ultrasonography.

Adolescent ; Body Mass Index ; Child ; China ; epidemiology ; Female ; Humans ; Insulin Resistance ; Logistic Models ; Male ; Non-alcoholic Fatty Liver Disease ; epidemiology ; Obesity ; epidemiology ; metabolism ; Prevalence ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo identify distinct proteins involved in human atherosclerosis obliterans (ASO) by a differential proteomic approach.

METHODSEight atherosclerotic femoral arteries with a mean age of 68.6 years (6 male and 2 female) and 5 normal femoral arteries with a mean age of 44.2 years (3 male and 2 female) were obtained from high amputation patients. Then the first 2-dimensional maps of the proteome of human femoral arteries was plotted to compare ASO and control specimens. Proteomic profiling was to differentiate and identify histological proteins that were associated with ASO. The differentially expressed proteins were sequenced by matrix assisted laser desorption/ionization mass spectrometry (MALDI-TOF-MS). The result was verified by immunohistochemistry (IHC) and Western blot.

RESULTSASO was associated with distinct patterns of protein expression in the femoral arteries. A total of 25 distinct spots corresponding to 13 different proteins were identified by MALDI-TOF-MS using the NCBI and IPI databases. These proteins were mainly involved in the pathogenetic mechanisms such as inflammation, oxidative stress, proliferation and transformation of SMCs. The low level of heat shock protein 27 (HSP27) in ASO was verified by IHC and western-blot in accord with the result of MS.

CONCLUSIONProteomic analysis can be used to investigate differentially expressed proteins, which may provide new insights into ASO pathogenesis, such as HSP27.

Adult ; Aged ; Arteriosclerosis Obliterans ; metabolism ; pathology ; Female ; Humans ; Male ; Middle Aged ; Proteome ; metabolism