Objective To calculate the probability of nurses in a city experiencing adverse event and investigate nurses′cognitive and attitude of adverse event reporting ,and to improve the adverse event reporting system for care .Methods Three hundred and seventy five nurses were selected from 15 hospitals in our city and investigated by questionnaire survey .Results There were not statistically significant difference in the probability of nurses experiencing adverse event among all the different levels hospitals (P>0 .05) .There were statistically significant difference among three factors influencing the probability of nurses experiencing adverse event ,including professional title ,different age ,length of service(P<0 .05) .There were statistically significant difference of actively reporting the adverse event among nurses with different length of service (P<0 .05) .Conclusion Nurses′cognitive and attitude to‐wards adverse events report is positive .The length of service ,punishment environment and management expectation are the factors influencing the executive intention of adverse events .Investigating safety problems from the systematic perspective and improving adverse events reporting system could get more information and synthetically analyze the information to avoid nursing risk events e‐ventually .

Objective To investigate the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) treatment of patients with alcohol dependence,anxiety and depression,and sleep problems.Methods 80 patients with alcohol-dependent patients were randomly divided into experimental group (40 cases) and control group (40 cases).All patients received routine treatment and care,the experimental group received additional rTMS to stimulate parts of the bilateral dorsolateral prefrontal region (DLPFC) 2 brain regions,each side 15 minutes at frequency of 1Hz,patient motion stimulus,intensity threshold (MT) of 80％,five times a week rTMS treatment,a total of 8 weeks,the control group received stimulation coil.Subjects were interviewed,as the time for the baseline,2 weeks,4 weeks and 8 weeks,assessment tools for the hamilton anxiety scale (HAMA),Hamilton depression rating scale (HAMD),Pittsburgh sleep quality index (PSQI).Results Compared with the pre-treatment,HAMA scores (19.5 ± 6.4,13.8± 5.3,7.3± 5.4 respectively) were significantly lower in 2,4,8 weeks after treatment (t 2 =11.29,P＜0.01;t 4=15.26,P＜0.01;t s =9.40,P＜0.01).Compared with the control group,HAMA scores were significantly lower in the experimental group after treatment (P＜0.01).Compared with the pretreatment group HAMD scores(17.5±6.6,11.2±4.9,6.1±5.2 respectively)were significantly lower in 2,4,8 weeks after treatment (t 2 =15.54,P＜0.01;t 4 =16.68,P＜0.01;t s =18.77,P＜0.01).Compared with the control group,HAMD scores were significantly lower in the experimental group after treatment (P＜0.01).Compared with the control group,PSQI scores were significantly lower in the experimental group in 2,4,8 weeks after treatment (t 2 =26.39,P＜0.01;t4=15.21,P＜0.01;ts=46.35,P＜0.01).Condusion Low-frequency rTMS treatment for alcohol dependence withdrawal symptoms can improve symptoms,such as anxiety and depression,sleep status.

Objective:To analyze the consistency between the histopathological results of routine endoscopy and biopsy in observing the gastric mucosa of patients with non-malignant gastroduodenal diseases,and to evaluate the necessity of biopsy following gastric endoscopy.Methods: From Jan.2005 to Dec.2005,320 patients who received upper gastrointestinal endoscopy and biopsy because of upper abdominal symptoms were included in this study.The patients were selected consecutively according to their disorders diagnosed by macroscopic endoscopy and were divided into 64 groups.The 5 patients in each group had reflux esophagitis,non-atrophic gastritis,atrophic gastritis,gastric ulcer and duodenal ulcer,respectively.Patients in the same group were matched with each other in gender,age and their history of diseases.The results of endoscopy,including the exudation,congestion,erosion,roughness,bile reflux,etc.,were read by 2 experienced endoscopists.The biopsy was performed by an experienced pathologist and pathological variables included active inflammation,chronic inflammation,atrophy,intestinal metaplasia and atypical hyperplasia.The status of Helicobacter pylori(H.pylori) infection was evaluated by rapid urea test,silver staining and histological methods;the result was deemed positive when the results of either 2 tests were positive.Results: Erosion,exudation,roughness,and H.pylori infection were related with active inflammation;erosion and H.pylori infection were related with chronic inflammation;roughness of mucosa was related with atrophy;roughness and H.pylori infection were related with intestinal metaplasia;and obsolete hemorrhage,H.pylori infection,roughness mucosa,and bile reflux were related with atypical hyperplasia.Macroscopic diagnosis rate of atrophic gastritis was 71.9%(46/64) with a false positive rate of 28.2%(18/64) and a false negative rate of 34.38%(22/64).Conclusion: Macroscopic diagnosis is indicative to pathological changes of gastric mucosa,but the predictive value is relatively poor,making biopsy and pathological examination necessary in the diagnosis of gastric mucosa disorders during routine endoscopic examination.

Humans ; von Hippel-Lindau Disease ; pathology

Objective To evaluate the reversal effect of a cholinergic receptor agonist on acantholysis in pemphigus,and to investigate its mechanism.Methods Human HaCaT keratinocytes were co-cultured with pemphigus vulgaris immunoglobulin G (PV-IgG) to establish a cell model of pemphigus,then classified into two groups to be incubated with the cholinergic receptor agonist carbachol for 12 hours (test group) or remain untreated (control group).Cell dissociation assay was performed to quantitatively estimate the reversal effect of carbachol on acantholysis,and immunofluorescence assay to qualitatively assess the changes of desmosomal proteins.Radio-immunoprecipitation assay (RIPA) lysis buffer and Triton X-100 were used to lyse HaCaT cells to obtain total proteins and cytoplasmic proteins,and Western blot was conducted to determine the expression levels of adhesion-related proteins desmoglein 3 (Dsg3) and plakoglobin (PG) on the surface of HaCaT cells,as well as the phosphorylation levels of p38 mitogen activated protein kinase (p38 MAPK) and epidermal growth factor receptor (EGFR) at different time points.Quantitative polymerase chain reaction (qPCR) was performed to detect the mRNA expressions of the above surface proteins,and coimmunoprecipitation assay to qualitatively evaluate the interaction between Dsg3 and PG.Results The number of cell debris was significantly lower in the test group than in the control group (18.67 ± 2.52 vs.46.67 ± 2.03,t =11.22,P＜0.01).Immunofluorescence assay showed that carbachol could reverse the internalization of desmosomal molecules induced by PV-IgG.In the pemphigus cell model,the levels of total Dsg3 and PG as well as non-desmosomal Dsg3 were decreased,while the level of non-desmosomal PG increased,and the interaction between Dsg3 and PG was attenuated.When the pemphigus cell model was co-cultured with carbachol,these above changes were reversed.Carbachol also increased the mRNA levels (expressed as 2-△△Ct) of Dsg3 and PG from 1.428 ± 0.215 and 1.563 ± 0.247 in the control group to 4.974 ± 0.948 (t =3.65,P =0.01) and 13.420 ± 1.715 (t =6.85,P ＜ 0.01) in the test group respectively.In phosphorylation assay,carbachol inhibited the phosphorylation of EGFR,but had no significant effect on that of p38 MAPK.Conclusions The cholinergic receptor agonist carbachol can reverse acantholysis in pemphigus,likely by inhibiting the internalization of Dsg3 and PG,enhancing their expressions and interaction,and suppressing the phosphorylation of the key signaling molecule for acantholysis,EGFR.

Objective To study the curative effect of nasal irrigation combined with backslapping for sputum suctioning on respiratory tract infections in infants . Methods Two hundred and forty-seven infants with respiratory tract infections were enrolled in the study and divided into the control group and the experiment group by the medical record number . On the basis of routine care , the experiment group was treated with nasal irrigation to clear secretions . Result The time for rales and cough disappearing in the experiment group was shorter than that in the control group , and the difference was statistically significant ( P<0 . 05 ) . Conclusions Nasal irrigation combined with backslapping for sputum suctioning can effectively ease the main symptoms and signs , enhance the ventilation function , enhance sleep quality and promote the rehabilitation of the disease .

Objective To study the induction of nitrous oxide(N2 O)and to compare safety and effec-tiveness of conscious sedation by nitrous oxide inhalation and intravenous sedation with propofol for upper gas-trointestinal(UGI)endoscopy.Methods A total of 400 patients undergoing UGI endoscopy in our hospital from April 2013 to October 2013 were randomly assigned to two groups,N2 O inhalation group(n=200)and in-travenous propofol group(n=200).The systolic pressures,diastolic pressures,heart rates and oxygen satura-tion,onset time,procedure duration,degree of sedation,recovery time,length of hospital stay,complica-tions,satisfaction ratings of doctors and patients,and the number of patients willing to accept the examination again were analyzed.Results The mean time of ideal anesthesia state for N2 O was (3. 16 ±0. 65 )min and there was no difference between the male and female(3. 16 ±0. 71)min vs.(3. 16 ±0. 58)min,t=0. 006,P>0. 05).The mean concentration was (43. 68 ±5. 05 )%,which was higher in male than that in female [(45. 3 ±4. 99)% vs.(41. 46 ±4. 30)%,t=3. 042,P<0. 05].Compared with before,the systolic pres-
sures,diastolic pressures,heart rates and oxygen saturation of patients in the propofol group significantly re-duced during the procedure(P<0. 05),while the same measurements excluding oxygen saturation for those in the N2 O group significantly increased(P<0. 05 ).Compared with the propofol group,patients inhaling N2 O had significantly shorter recovery and hospital stay time,but a longer onset time and procedure duration(P<0. 05 ).Complications that occurred in some patients of propofol group included hyoxemia,hypotension,brady-cardia,while the major complication in the N2 O group was nausea.The satisfaction ratings of doctors or pa-tients and the number of patients willing to accept the examination again in N2 O group were smaller than those in propofol group(86 ±3. 7 vs.96 ±2. 6,87 ±2. 8 vs.98 ±1. 2,87%vs.99%,P<0. 05).Conclusion Both conscious sedation by N2 O inhalation and intravenous sedation with propofol are effective for diagnostic UGI en-doscopy,but the safety of the former is superior to the latter.The key to complete the conscious sedation by ni-trous oxide inhalation is to accurately identify the ideal anesthesia state of N2 O.It is significant to pay attention to the nine factors concerning safe and effective sedation during operation.

Purpose To investigate the clinicopathological features of multilocular cystic renal cell carcinoma ( MCRCC) , and to im-prove the understanding of this disease. Methods Thirty-two of MCRCC were studied by clinic data, pathological features and immu-nophenotype. All the thirty-two cases were followed up. Results In this study, thirty-two patients were diagnosed as MCRCC with a male-to-female ratio of 2.2 : 1, thirteen of whom had the tumor in the left kidney, eighteen in the right kidney, another in the double kidneys. The mean of tumor diameter was 4.6 cm (1.0~8.0 cm). Eleven patients underwent radical nephrectomy while the other 21 patients received nephron sparing surgery. Microscopically, all the cases were multiocular, lined in the cyst wall by a single layer of tumor cells with the clear or pale cytoplasm and Fuhrman grade 1 nuclei. Occasionally, the lining consisted of several layers of tumor cells or a few small papillae were present. The linings of the cyst wall were rich in thin-wall blood vessels. Immunohistochemically, the tumor cells were positive for CK(32/32), CK7(25/32), EMA(32/32), CD10(23/32) and vimentin(20/32), while negative for CD68. Conclusions MCRCC is characteristic by low grade nuclei, lacking solid nodules, and in the cyst wall, and has a favourable prognosis. The rich in thin-wall blood vessels and the lining cells with the clear or pale cytoplasm are diagnosis clues.

In plants, oxidative stress is one of the major causes of damage as a result of various environmental stresses and it is primarily due to the excessive accumulation of reactive oxygen species. To develop transgenic potato plants with enhanced tolerance to environmental stress, transgenic potato plants (Solanum tuberosum L. cv. Atlantic) expressing the Cu/ZnSOD and APX genes in chloroplasts were generated under the control of the oxidative stress-inducible promoter. To investigate oxidative stress tolerance, transgenic plants were evaluated at the level of leaf discs and plantlets after methyl viologen (MV) and salt treatment. Leaf discs from transgenic potato plants showed 13% less membrane damage compared to non-transgenic (NT) plants suffering 10 μmol/L MV treatment of 48 h, and showed 1.6-fold higher chlorophyll contents than those of NT plants at 1.0mol/L NaCl treatment (31% vs. 19%). In addition, transgenic potato plants maintained higher rooting rates (75%) during 100mmol/L NaCl treatment than those (12%) from NT plants. Moreover, the tolerance to salt stress in transgenic plants was consistent to increased transcript levels and higher activities of SOD and APX compared to NT plants. These results suggest that expression of Cu/ZnSOD and APX in chloroplasts could be used in plants to enhance the tolerance to environmental stresses.

Potato cultivar Atlantic is widely grown for potato chips in the world. However, this economically important potato cultivar exhibits very poor yields and traits under severe environmental stress. To develop an efficient plant transformation system that could be used to produce large scale transgenic potato plants with enhanced tolerance to environmental stress and therefore would be beneficial for potato processing industry, Agrobacterium-mediated transformation of internodal stem explants using both superoxide dismutase (SOD) and ascorbate peroxidase (APX) genes under the control of an oxidative stress-inducible SWPA2 promoter was performed. Comparing to leaf explants, stem internodal explants were less liable to damage during manipulation, more amenable to in vitro conditions. The addition of silver thiosulfate to the selection medium considerably promoted the shoot induction from explant-derived callus. Seven to nine shoots per stem explant were obtained. By combining the best treatments, this system yielded shoot induction frequency of 94.2% and transformation frequency of 80% of internodal stem explants. Stable integration of the transgenes was confirmed by PCR and Southern blot analyses. In conclusion, short duration (7～8 weeks), high efficiency and easy process make this system well suited for wider commercial applications of transgenic Atlantic potato plants.