Objective To explore the correlation between the clinical nurses’turnover intention and their job satisfaction of their present working status.Method The Mueller/Mccloskey Satisfaction Scales(MMSS)and Turnover Intention Scale(TIS)were employed to implement the questionnaire survey among 531 registered nurses from a hospital in Taishan,Guangdong.Results The total scores on nurses turnover intention and their job satisfaction were(3?34±0?40)and(14?54±1?38)respectively.The opportunity for professional improvement,welfare and income,balance between job and family were negatively correlated with their turnover intention (all P<0?05).Conclusions The nursing administration should look into the conditions of nurse’s turnover intention and their job satisfactions so that they can take effective measures to improve their job satisfaction and decrease their turnover intention.

Objective To explore the design and application of the multifunctional treatment beds on patients′ position compliance and comfort after intraocular retinal reattachment surgery. Methods Eighty-six patients needing special position nursing after intraocular retinal reattachment surgery were randomly divided into experiment and control groups. The former received the special multifunction treatment beds while normal ward beds were used for the control patients . The position compliance , comfort and the complications were observed one month after surgery. Result The position compliance and the degree of comfort in the experiment group were significantly better than those in the control group and the complication rate was significantly lower than that of the control group (all P<0.05). Conclusion The special multifunction treatment beds can be effective in increasing the patients compliance in positions and compliance as well as reducing postoperative complications and increasing the operation success rate.

ObjectiveTo observe the clinical efficacy of plasmapheresis plus acupoint injection in treating severe hepatitis. MethodSixty patients with severe hepatitis were randomized into a treatment group of 31 cases and a control group of29 cases. The two groups both received plasmapheresis in addition to the comprehensive internal medicine treatment, while thetreatment group simultaneously received acupoint injection withHuang Qi(Radix Astragali) at Zusanli (ST 36). After the intervention, the symptoms, signs, liver function, blood coagulation, and blood ammonia were observed in the two groups.ResultAfter the intervention, the symptoms, signs, and biochemical indexes were significantly improved,and theindexes in the treatment group were significantly different from that in the control group (P<0.05,P<0.01), and the total effective rate of the treatment group was markedly higher than that of the control group (P<0.05).ConclusionPlasmapheresis plus acupoint injection can effectively improve the short-term condition of the patients, enhance therapeutic efficacy, with fewer adverse reactions.

ObjectiveTo analyze the status of DACH1 gene promoter methylation and explore its association with the expression of DACH1 gene promoter methylation and clinical significance of endometrium carcinoma(EC).Methods From February 2004 to August 2008,a total of 80 EC tissue samples with comprehensive surgical pathology staging were collected and used for this study.Twenty normal endometrium tissues in 2008 were abtained from the fractional curettage because of dysfunctional uterine bleeding as control.All samples were confirmed pathologically.Methylation specific PCR (MSP) was performed to detect the promoter methylation of DACH1 gene,and analyze its influence on the expression of DACH1 and the relationship between DACH1 promoter methylation and clinicopathological factors in EC.DACH1 protein expression was detected by western blot.Chi-square test and Pearson test were used for statistical analysis.ResultsThe rate of promoter methylation of DACH1 gene in the EC tissues was significantly higher than that in the normal endometrium issues (30％ vs.5％,P ＜ 0.05).There was an association between the expression of DACH1 and DACH1 gene promoter methylation ( r =- 0.30,P ＜ 0.01 ).There was statistical difference between the methylation of DACH1 and the pathological grade ( P ＜ 0.05 ) or histological type ( P ＜0.05).But DACH1 gene methylation was not related with the age,stage,myometrial invasion depth and lymphnode metastasis (P ＞ 0.05 ).Conclusions DACH1gene promoter methylaion could lead to a decrease or absence in the DACH1 expression in EC.The promoter methylation of DACH1 gene may induce the inhibition of DACH1 expression,which might be one of the mechanisms of DACH1 gene inactivation in human EC.

Objective To investigate the influence of plasma exchange with acupuncture point injection therapy on liver fibrosis indexes in patients with severe hepatitis. Methods Sixty patients with severe hepatitis were randomly divided into group A with 29 cases receiving plasma replacement and group B of 31 cases receiving astragalus injection at Zusanli point in addition to plasma replacement. Changes of liver fibrosis indexes including serum hyaluronic acid (HA), laminin (LN), collagenⅣ(Ⅳ-C), typeⅢpre-collagen (PCⅢ) were observed, which were compared with those from group C with 30 healthy subjects. Results Before treatment, there was no statistical significance in comparison of liver fibrosis index in group A and B (P>0.05), but all the indexes were higher than those in group C (P<0.001). After treatment, the level of each index in group A and B was down with a more significant change in group B and the comparison of both groups indicated statistical significance (P<0.05 or P <0.001);Compared with those in group C, changes ofⅣ-C, PCⅢin group B showed no significant difference (P>0.05). Conclusion Plasma exchange with astragalus injection at Zusanli point can effectively improve liver fibrosis indexes in patients with severe hepatitis and then improve the prognosis of patients.

Objective To study the relationship between the level of serum thrombomodulin (TM ) ,radiation dose-volume factors with acute radiation pneumonitis (ARP) .Methods 54 patients with lung cancer were given the routine 3 -dimensional conformal radiation therapy(3DCRT) and chemotherpy ,20 cases received the concurrent radiochemotherapy and 34 cases were performed the the sequential chemotherapy .The serum TM level was measured with enzyme-linked immunosorbent assay(ELISA) before radio-therapy(B-RT) and at 30 Gy(M-RT) in radiotherapy .The ARP grade was evaluated according to the criteria of the Common Ter-minology Criteria for Adverse Events(CTCAE v3 .0) by the National Caner Institute(NCI) ,grade 2 or more was taken as ARP . The relationship between the serum TM level ,dose-volume factors with ARP was analyzed .Results 20 cases (37% ) had ARP .12 cases got grade 2 ARP and 8 cases had grade 3 .The occurrence rates of ARP in the minimal lethal dose (MLD) Gy <10 and >10 groups ,V5 < 50% and ≥ 50% groups ,V10 < 40% and ≥ 40% groups ,V20 < 25% and ≥ 25% groups ,V30 < 13% and ≥ 13%groups ,TM decrease group and TM increase group after 30 Gy radiation were 8% vs .62% ,7% vs .69% ,21% vs .75% ,28% vs . 56% ,15% vs .57% and 50% vs .13% respectively ,the differences had statistical significance (χ2 = 16 .83 ,22 .29 ,14 .05 ,3 .97 , 10 .08 ,6 .46 ,P<0 .05);in the ARP group and non-ARP group ,MLD ,V5 ,V10 ,V20 and V30 were (12 ± 2) vs .(9 ± 2) ,(58 ± 10) vs .(43 ± 10) ,(42 ± 8) vs .(30 ± 8) ,(23 ± 3) vs .(19 ± 6) ,(15 ± 4) vs .(11 ± 4) respectively ,the differences had statistical signifi-cance (t= -4 .96 ,-5 .27 ,-5 .70 ,-3 .37 ,-3 .61 ,P<0 .05) .Conclusion Multiple dose-volume parameters are associated with the occurrence rate of ARP .The patients with decreased serum TM level after radiotherapy are liable to develop ARP .

Wake up ischemic stroke (WUIS),also known as awakening stroke,refers to patients with no new stroke symptoms during sleep,but after waking up,the patients or witness who found the acute cerebral infarction with stroke performance.The key to the treatment of acute ischernic stroke is to effectively restore reperfusion within the time window.The original intravenous recombinant tissue-type plasminogen activator (rt-PA) thrombolytic therapy,is widely recognized as an effective treatment method of choice for 4.5h onset of acute ischemic stroke reperfusion.Because the exact onset time of WUIS is unclear and limited by current scientific and technical levels,intravenous thrombolysis may lead to an increased risk of intracranial hemorrhage.Therefore,the American Heart Association and the American Stroke Association (AHA/ASA) were included in the "Intravenous Thrombolysis".Intravenous thrombolysis is not recommended in the Standard Scientific Statement.Patients who may be suitable for thrombolytic therapy are not able to obtain thrombolytic therapy,resulting in poor clinical prognosis.In recent years,with the further development of relevant clinical research and the rapid development of imaging technology,the latest research found that multi-mode imaging examination is safe and effective for intravenous thrombolytic therapy in patients with poststroke stroke.Multi-mode imaging studies help screening patients with acute reperfusion therapy,so that part of WUIS patients will benefit from the acute reperfusion therapy.This article reviews and summarizes the literature findings of WUIS in recent years.The pathophysiological changes,clinical features and imaging changes of patients with WUIS and non-WUIS are almost unanimously.Early CT and MRI examinations can help to extend acute stroke treatment to patients with WUIS.At present,for this type of patients,there are great research progress in the formulation and implementation of clinical treatment strategies.This article will briefly summarize the research progress and treatment status of WUIS.

OBJECTIVE: To investigate the therapeutic effect of electroacupuncture on peripheral nerve damage induced by 1-bromopropane( 1-BP) exposure.METHODS: A total of 25 specific pathogen free healthy adult male Wistar rats were randomly divided into blank control group( n = 5),model control group( n = 10),and electroacupuncture treatment( EA) group( n = 10).Rats in the blank control group were not exposed to 1-BP and treated with electroacupuncture.The rats in model control group and EA group were placed in a dynamic inhalation exposure cabinet with 1-BP at concentration of 5 000 mg/m~3.The rats were continuously exposed to 1-BP 8 hours per day,5 days a week,for 4 weeks.At the 3 rd day after the end of the exposure,the EA group was treated with electroacupuncture on“Zu sanli”and“Huantiao”points for 4 courses.Each course included 20 minutes each time,once per day for 7 consecutive days.The body weight,the motor nerve conduction velocity( MCV) and sense nerve conduction velocity( SCV) of sciatic nerves on both posterior limbs of the rats were measured.RESULTS: During the course of 1-BP exposure,the rats in the EA and model control group showed reduction of eating,drinking and activities,limited autonomic activities and their hind limbs dragged.The MCV and SCV of posterior limb sciatic nerve of rats in the model control group were slower than that of the control group at the 4 th,6th and 8th week and the 0 week of the same group( P < 0.05).The MCV and SCV of posterior limb sciatic nerve of rats in the EA group improved with the increase of treatment time( P < 0.05),and those at the 6th and 8th weeks of the experiment( corresponding to the 2nd and 4th week after treatment) were faster than that of the model control group at the same time( P < 0.05).The SCV of the posterior limb sciatic nerve in the EA group recovered to normal level 4 weeks after treatment compared with the blank control group( P < 0.05).CONCLUSION: Electroacupuncture treatment can promote the recovery of peripheral nerve damage in rats with 1-BP poisoning.

Brucella is an intracellular pathogen that invades a host and settles in its immune cells; however, the mechanism of its intracellular survival is unclear. Modification of small ubiquitin-related modifier (SUMO) occurs in many cellular activities. E2 conjugating enzyme 9 (Ubc9) is the only reported ubiquitin-conjugating enzyme that links the SUMO molecule with a target protein. Brucella's intracellular survival mechanism has not been studied with respect to SUMO-related proteins and Ubc9. Therefore, to investigate the relationship between Brucella melitensis 16M and SUMO, we constructed plasmids and cells lines suitable for overexpression and knockdown of SUMO1 and Ubc9 genes. Brucella 16M activated SUMO1/Ubc9 expression in a time-dependent manner, and Brucella 16M intracellular survival was inhibited by SUMO1/Ubc9 overexpression and promoted by SUMO1/Ubc9 depletion. In macrophages, Brucella 16M-dependent apoptosis and immune factors were induced by SUMO1/Ubc9 overexpression and restricted by SUMO1/Ubc9 depletion. We noted no effect on the expressions of SUMO1 and Ubc9 in B. melitensis 16M lipopolysaccharide-prestimulated mouse RAW264.7 macrophages. Additionally, intracellular survival of the 16M△VirB2 mutant was lower than that of Brucella 16M (p < 0.05). VirB2 can affect expression levels of Ubc9, thereby increasing intracellular survival of Brucella in macrophages at the late stage of infection. Collectively, our results demonstrate that B. melitensis 16M may use the VirB IV secretion system of Brucella to interact with SUMO-related proteins during infection of host cells, which interferes with SUMO function and promotes pathogen survival in host cells.
Animals ; Apoptosis ; Brucella melitensis ; Brucella ; Immunologic Factors ; Macrophages ; Mice ; Plasmids

[ Abstract] Objective To investigate the clinical efficacy of preoperative three-dimensional radiotherapy (3DRT) with or without concurrent chemotherapy for esophageal carcinoma.Methods We retrospectively analyzed 103 esophageal carcinoma patients who received preoperative 3DRT with or without concurrent chemotherapy from 2004 to 2014 in Cancer Hospital CAMS.The median radiation dose was 40 Gy, and the TP or PF regimen was adopted for concurrent chemotherapy if needed.The overall survival (OS) and disease-free survival ( DFS) were calculated by the Kaplan-Meier method, and the survival difference and univariate prognostic analyses were performed by the log-rank test.The Cox proportional hazards model was used for multivariate prognostic analysis.Results The number of patients followed at 3-years was 54.The 3-year OS and DFS rates were 61.1% and 54.9%, respectively, for all patients.There were no significant differences between the 3DRT and concurrent chemoradiotherapy (CCRT) groups as to OS (P=0.876) and DFS (P=0.521).The rates of complete, partial, and minimal pathologic responses of the primary tumor were 48.0%, 40.2%, and 11.8%, respectively.There were significant differences in OS and DFS between the complete, partial, and minimal pathologic response groups (P=0.037 and 0.003). No significant difference in pathologic response rate was found between the 3DRT and CCRT groups (P=0.953).The lymph node metastasis rate was 26.5%, and this rate for the complete, partial, and minimal pathologic response groups was 14%, 30%, and 67%, respectively, with a significant difference between the three groups (P=0.001).The OS and DFS were significantly higher in patients without lymph node metastasis than in those with lymph node metastasis (P=0.034 and 0.020).The surgery-related mortality was 7.8% in all patients.Compared with the 3DRT group, the CCRT group had significantly higher incidence rates of leukopenia (P=0.002), neutropenia (P=0.023), radiation esophagitis (P=0.008), and radiation esophagitis ( P=0.023).Pathologic response of the primary tumor and weight loss before treatment were independent prognostic factors for OS and DFS (P=0.030,0.024 and P=0.003,0.042). Conclusions Preoperative 3DRT alone or with concurrent chemotherapy can result in a relatively high complete pathologic response rate, hence increasing the survival rate.Further randomized clinical trials are needed to confirm whether preoperative CCRT is better than 3DRT in improving survival without increasing the incidence of adverse reactions.