Objective To investigate and analyze the status quo of job satisfaction of nurses in a large 3-A-grade hospital in Tianjin. Methods Using stratified random sampling method, the general information questionnaire and the nurse job satisfaction scale were used to investigate the cross-sectional survey of 435 clinical nurses in large 3-A-grade hospital in Tianjin. Results The score of job satisfaction was (123.54±15.52) points, which was at the middle level. According to single factor analysis, there were significant differences in the influence of nurses′ job satisfaction on age, working life, department, monthly average night shift frequencies, monthly gross income (F=2.238-7.622, all P<0.05). There was a significant difference in job satisfaction among nurses with different income(F=2.642, P=0.049), among whichwork load,relationship with colleaguesandjob itselfhad the most significant impact on job satisfaction(F=2.667, 6.087, 4.023, all P<0.05). Conclusions Nursing managers should be rational allocation of human resources, reduce the workload of nurses, to build a harmonious atmosphere in the team, to create a good working environment, provide a better career development platform for nurses, implement flexible management, improve nurses′job satisfaction.

Objective Explore the diagnostic effect of high-sensitivity C-reactive protein (hs-CRP) in pediatric infectious diseases. Methods The BNProSpec automatic protein analyzer was used to detect the serum hs-CRP levels of children including 246 cases of bacterial infection, 132 cases of virus infection and 72 cases of healthy children (control group) . Results The serum hs-CRP levels were 57.2±19.5 mg/L,4.6±3.2 mg/L and 1.7 ±0.4mg/L in children of the bacterial infection, virus infection and normal control group, respectively. Conclusion The serum levels of hs-CRP in children with bacterial infection were significantly higher than those in other two groups,and the difference was significant ( <0.05) . The results suggested that serum hs-CRP testing has great application value in the diagnosis of pediatric infectious diseases, treatment and prognosis.

Objective To investigate effects of continuous positive airway pressure (CPAP)treatment on pulmonary function, frequency of asthmatic attack, and quality of life in patients of moderate to severe obstructive sleep apnea syndrome (OSAS) accompanying with asthma. Methods Twenty-three patients of OSAS accompanying with mild-to-moderate asthma were studied. They were divided into two groups, gastroesophageal reflux ( GER ) group ( n = 9 ) and non-GER group ( n = 14 ), based GER questionnaire score equal to or greater than 12, or less than 12. Pulmonary function tests (PFTs), Epworth sleepy score (ESS), quality of life for obstructive sleep apnea (QOLAp) score, quality of life for asthma (QOLAs) score and polysomnography (PSG) were measured for all the patients before and after four-week CPAP, respectively. Results No significant difference in PFTs was revealed before and after four-week CPAP between the two groups. However, there was significant difference in scores of QOLAp, ESS and QOLAs before and after four-week CPAP treatment, ( 12. 8 ± 2. 8 ) and (4. 6 ± 0. 9), ( 5. 1 ± 0. 7 ) and (6.3 ±0.6), and (4. 1 ±0.5) and (6.3 ±0.5) in GER group, and (13.0 ±2.9) and (4.6 ± 1.1),(4.7±0.5) and (5.6±0.6), and (3.6±0.3) and (5.8 ±0.6) in non-GER group, respectively (P＜0. 01 or 0. 05). Frequencies of asthmatic attack and nocturnal asthmatic attack reduced to ( 1.7 ± 1.1 )episodes per week and (0. 7 ± 0. 3) episodes per week after four-week treatment from (2. 9 ± 2. 0) episodes per week and ( 1.4 ± 0. 8) episodes per week before treatment ( P ＜ 0. 05 ) in GER group, but no significant difference was found before and after treatment in non-GER group. Scores of QOLAs increased more significantly in GER group than that in non-GER group ( P ＜ 0. 05 ). Conclusion CPAP treatment can significantly improve quality of life, rather than pulmonary function, in patients of OSAS accompanying with asthma, especially in those with GER symptoms.

Objective To investigate the effects of soluble CD40 ligand combined with LY294002,a specific inhibitor of phosphatidylinositol 3-kinase,on proliferation and invasion of gastric cancer cells (AGS ) and its potential mechanisms. Methods The effect of gradient concentration of sCD40L and its combination with LY294002 on cellular proliferation was determined using MTT assay. The ability of cellular invasion and migration was evaluated by wound healing and Transwell invasion assay. The protein expression of PI3K, p-Akt and vascular endothelia growth factor (VEGF) was tested by Western blotting. Results The inhibitory effect of cellular proliferation in sCD40L, LY294002 and sCD40L + LY294002 groups was 70. 1%, 65. 7% and 41. 3%, respectively, with significant difference (P<0. 05). And wound healing was also delayed in cells treated with sCD40L plus LY294002 when compared with those treated with sCD40L or LY294002. These results indicated that the inhibitory effect of cellular proliferation, migration and invasion was enhanced when cells were treated with sCD40L plus LY294002. The protein expression of PI3K,p-Akt and VEGF increased in cells treated with sCD40L, but reduced drastically in cells treated with sCD40L plus LY294002. Conclusion Inhibiting PI3K/Akt signaling pathway may enhance the inhibitory effect of proliferation, migration and invasion by sCD40L on AGS cells, which provide a new way for biochemical therapy of gastric cancer.

Objective To compare the reduction in left ventricular hypertrophy (LVH) caused by monotherapy with ramipril or losartan or the combination of these two drugs,in patients with hypertensive LVH and to evaluate the value of three-dimensional echocardiography (3DE) on LVH regression.Methods Ninety-six essential hypertensive patients with LVH were enrolled in this study.All patients were randomly divided into 3 groups: ramipril group,losartan group,combination group with ramipril and losartan.Left ventricular mass(LVM) was calculated by M-mode echocardiography,two-dimensional echocardiography and 3DE at baseline and after 6 months treatment with ramipril or losartan.Results Of 96 patients enrolled,59 patients have complete follow-up datum.LVM of ramipril,losartan and combination group decreased 16.9% , 17.9% and 18.8% compared with before treatment.LVM by 3DE decreased 11.6% , 14.7% and 13.6% respectively.The difference of LVM derived from 3DE showed obviously lower than derived from M-mode echocardiography.Conclusions Applying M-mode echocardiography and two-dimensional echocardiography to evaluate the regression of LVH will overestimate the effects of drugs.Three-dimensional echocardiography may detect the changes of LVM more accurately.

Objective To evaluate the effects of angiotensin converting enzyme inhibition(ACEI) or angiotensin II receptor blocker(ARB) on coronary hemodynamics in hypertensive patients with left ventricular hypertrophy(LVH) by Doppler ultrasound.Methods Sixty essential hypertensive patients with LVH were enrolled in this study.All patients were randomly divided into 3 groups: ramipril group,losartan group and combination group.Left ventricular mass(LVM) was calculated by three dimensional echocardiography and coronary hemodynamics was evaluated by transesophageal echocardiography with left anterior descending artery.Coronary flow reserve(CFR) was calculated as the ratio of coronary flow velocity,after intravenous injection of dipyridamole,to rest peak velocity.All the indexes of the coronary hemodynamics were corrected by LVM.Results Fifty patients had complete follow up datum.The systolic blood pressure(SBP),diastolic blood pressure(DBP) and LVM were significantly decreased in ramipril,losartan and combination group after 6 months′ treatment (All P

Objective To explore the effects of exercise with psychological rehabilitation on motor function of upper limbs for stroke patients with hemiplegia. Methods 34 stroke patients with hemiplegia were divided into treatment group (n=17) and control group (n=17). Both groups were treated with basic medication and exercise while the treatment group received psychological rehabilitation additionally. The motor function of upper limbs was evaluated with Fugl-Meyer assessment (FMA), and activities of daily living was assessed with Barthel index (BI) before and after treatment. Results After treatment, the scores of FMA and BI improved significantly in both groups (P<0.001), and was better in the treatment group than in the control group (P<0.001). Conclusion Exercise with psychological rehabilitation can effectively improve the motor function of upper limbs and activities of daily living for stroke patients with hemiplegia.

BACKGROUND: The elevation of plasma fibrinogen(Fbg) is a key risk factor of cerebrovascular diseases. The evaluation of the monomer polymerization function of fibrin has even more important clinical merit than the detection of Fbg level.OBJECTIVE: To investigate the clinical significance of the monomer polymerization function of fibrin in patients with isehemie cerebrovascular diseases and its impacts on rehabilitative intervention.DESIGN: A case control study employing patients and healthy individual as subjects.SETTING: An Institute of Hematology and Department of Neurology of one university.PARTICIPANTS: Totally 110 patients with different ischemic cerebrovascular disease selected from the Department of Neurology, Union Hospital of Tongji Medical College, Huazhong Science and Technology University from September 2001 to March 2002, and 50 healthy individuals were included in the study.METHODS: Rehabilitative intervention was performed in 31 randomly selected cerebral infarct patients, and the parameters indicating the monomer polymerization functions of fibrin in the plasma were detected by the measurement system for the monomer polymerization function of fibrin.MAIN OUTCOME MEASURES: Abnormal condition of monomer polymerization function of fibrin in each parameter.RESULTS: Each parameter indicating the monomer polymerization functions of fibrin in plasma was significantly increased in ischemic cerebrovascular diseases patients than healthy individuals( P ＜ 0.01 ) . The abnormal rate of Fbg leveland fibrin monomer polymerization velocity (FMPV) was significantly elevated in ischemic cerebrovascular disease patients than healthy individuals ( P ＜ 0. 01 ) . The relative risk(RR) of ischemic cerebrovascular diseases in patients with abnormal FMP functions was 4 to 31 times more than healthy control group. In cerebral infarct group, FMPV of anterior circulation infarct subgroup was significantly elevated than that of posterior circulation infarct and lacunar cerebral infarct subgroups( P ＜ 0.05). The FMP function of anterior cerebral infarct patients was significantly higher than that of healthy group before rehabilitative intervention. Although each FMP parameter reduced after rehabilitative intervention, the difference between was not significant compared with that of before therapy.CONCLUSION: FMP function analysis can completely and objectively reflect the coagulation status of the patients with ischemic cerebrovascular diseases, and it can also reflect the range and severity of infarct to some extent. Although common rehabilitative intervention cannot effectively improve the high-coagulation of the blood, the impacts of specific rehabilitative intervention on the coagulation mechanism deserve further investigation.

Objective To explore the evaluation value of modified USA National Institutes of Health Stroke Scale (mNIHSS) score combined with bedside transcranial Doppler ultrasonography (TCD) on the early prognosis of ischemic stroke (AIS).Methods One hundred and thirty-six anterior circulation AIS patients were collected,mNIHSS score was evaluated on admission,and emergency bedside TCD examination was performed to evaluate vascular anomalies.After active treatment after discharge,the modified Rankin scale (mRS) score was recorded to evaluate 90 d prognosis.The value of mNIHSS score combined with TCD examination analysis on the prognosis was analyzed.Results If the mNIHSS score ＞ 8 scores was judged to be poor prognosis,the sensitivity was 0.684,the specificity was 0.806,the positive predictive value was 0.578,the negative predictive value was 0.868.If related macro vascular abnormalities in bedside TCD examination were evaluated for clinical prognosis,the sensitivity was 0.736,the specificity was 0.643,the positive predictive value was 0.444,the negative predictive value was 0.863.If both,the specificity was 0.918,the positive predictive value was 0.714,the positive likelihood ratio was 6.41 ;and the two were not available,the negative predictive value was 0.928,negative likelihood ratio was 0.20.Conclusion mNIHSS score combined with TCD examination in evaluating the prognosis of AIS patients can improve the positive or negative predictive value.

Objective To analyze TORCH infection situation in 6 027 cases of pregnant women,puerperae and neonates.Methods The TORCH IgM and IgG was detected by using ELISA for 6 027 cases of pregnant women,puerperae and neonates,and the positive rates of the antibodies to variant TORCH pathogens were analyzed.Results The positive rates of HSVⅠ-IgM,HSVⅡ-IgM,RV-IgM,TOXO-IgM and CMV-IgM were 0.02%,0.02%,0.12%,0.12% and 0.20% respectively.The positive rates of HSVⅠ-IgG,HSVⅡ-IgM,RV-IgM,TOXO-IgM,and CMV-IgM were 63.32%,13.31%,52.83%,12.68% and 58.57% respective-ly.Positive rate of CMV-IgM in neonates was higher than that in pregnant women,the difference was statistically significant(P <0.05).There were totally 28 cases of neonataes detected with acute CMV infection.Conclusion TORCH screening in pregnant women,puerperae and neonates helps the detection of infection disease in perinatal period.