Objective To establish the charge nurses'evaluation system and evaluate their work by comprehensive index to make the assessment more scientific.Methods The comparison value of different assessment factors were established by 4 rounds of expert consultations by the analytic Hierarchy Process (AHP)and Delphi method.The index weight was confirmed and passed the coherence test(CR＜0.01).The combined index weight and comprehensive index were also obtained.Results The charge nurses'evaluation system containing 4 one-dimension targets(including internal nursing quality,patients satisfaction degree,individual professional spirit and study and development)and 17 two-dimension targets were set up.Conclusion The combination of AHP and Delphi method supplied a simple and prompt evaluation model though currently it is difficult to estimate management personnels objectively and fairly.

Src family kinases (SFKs) are the largest non-receptor tyrosine kinase family and play key roles in the regulation of cell morphology,proliferation,growth,adhesion,and motility.The activation of src kinases couples with many signals input on cell surface,including growth factor,cytokine,immune cell receptor,G protein-coupled receptor,integrin,and other cell adhesion molecules.In addition,as an important molecular switch connecting many extracellular and intracellular important signaling pathways,src kinases also play an important role in the occurrence of cerebrovascular diseases.

Objective To evaluate the short-term effects of three-dimensional conformal radiotherapy (3D-CRT) associated with transcatheter arterial chemoembolization (TACE) in the treatment of primary hepatic carcinoma and 3D-CRT associated with chemotherapy in the treatment of metastatic hepatic carcinoma. Methods In 52 patients with primary hepatic carcinoma, first of all a single TACE was conducted. Then after an interval of 2 weeks, the conformal radiotherapy was given, with a radiation dose of 2~3 Gy every fraction, once daily or once every other day and 3~5 fractions every week. The total radiation dose to the target was 42.2~60.0 Gy (mean, 52.2 Gy). Afterwards, 2 additional TACEs were given after the radiotherapy. In 35 patients with metastatic hepatic carcinoma, chemotherapy was carried out for 1 treatment course firstly. Then 3D-CRT was employed. After the radiotherapy, another 2 courses of consolidating chemotherapy were administrated. The patient continued with the chemotherapy for additional 3 treatment courses (a total of 6 courses) if efficacy evaluation showed the patient had responded to the chemotherapy. Results The response outcomes were: complete remission (CR) 23 0% (20/87), partial remission (PR) 39 1% (34/87), stable disease (SD) 34 5% (30/87) and progressive disease (PD) 3 4% (3/87), the response rate (RR) being 62 1% (54/87). Conclusions 3D-CRT with TACE for primary hepatic carcinoma and 3D-CRT with chemotherapy for metastatic hepatic carcinoma offers high local control rates and good short-term effects.

Objective To explore the perioperative antithrombotic strategy in percutaneous coronary intervention(PCI)for the patients with coronary heart disease(CHD)who were treated with long-term warfarin anticoagulation,and to evaluate the safety of the strategy and short-term efficacy.Methods The clinical data of 76 patients were analyzed,who underwent coronary stenting while treated with long-term warfarin anticoagulation.All of them had unstable angina.The reasons of requiring warfarin anticoagulation were cardiac valve replacement [51(67.1%)],pulmonary embolism within half a year [6(7.9%)],and sustained atrial fibrillation at high risk of stroke [19(25.0%)].Warfarin was withdrawn and low molecular weight heparin(LMWH)was administered as alternative anti-thrombus drugs before PCI.PCI was performed when international normalized ratio(INR)went less than or equal to 1.3.LMWH was administered combined with low dose aspirin(100mg/d)and clopidogrel(75mg/d)post PCI,while warfarin was resumed too.When INR arrived at 1.8,LMWH was withdrawn.Warfarin was administered in a dose adjusted to achieve the target INR of 1.8 to 2.3.Clopidogrel was withdrawn 1 month later.Aspirin(75-100mg/d)was continued,and then warfarin was resumed to the dose before PCI.The data of the incidence of ischemic events,major adverse cardiac events(MACE),subacute instent thrombus(SAT),and hemorrhage events during hospital period were analyzed.Results The incidence of hemorrhage events was 5.3%(4/76),one of them was secondary hemorrhage events.The rate of MACE was 1.3%(1/76).No main hemorrhage events and SAT occurred during hospitalization related to regulating antithrombotic strategy.Conclusions As alternatives of warfarin,LMWH is taken before PCI,and then the low dose of aspirin,clopidogrel,LMWH and warfarin are admitted in a short period after PCI,the dosage of warfarin should be accurately adjusted according INR post PCI,and then the LMWH is taken out of service timely,such a strategy is safe and efficient in peri-percutaneous coronary intervention for the patients with CHD who were treated with maintaining warfarin anticoagulation.

Objective To establish a new method for determination of copper, nickel, silver, lead, cadmium and mercury in water with solid phase extraction followed by rapid high performance liquid chromatography. Methods The copper, nickel, silver, lead, cadmium and mercury ions were pre-column derived by tera-(4-dimethylaminophenyl)-porphine (T4-DMAPP). These chelates were enriched by solid phase extraction with C18 cartridge and the 100 times enriched products of were obtained. The chelates were separated on a ZORBAX Stable Bound (4.6 mm?50 mm, 1.8 ?m) by gradient elution with methanol and THF as mobile phase at a flow rate of 2.0 ml/min and detected with photodiode array detector from 350-600 nm. Results The detection limits of nickel, copper, silver, lead, cadmium, and mercury were 3, 2, 4, 3, 1.5 and 3 ng/L respectively, the recovery rates were 92%-104%, relative standard deviations were 2.8%-3.5%. Conclusion This method can be applied to the determination of nickel, copper, silver, lead, cadmium, and mercury in water with good results.

Object To set up a determination method for aucubin in three medicinal plants of Pedicularis L Methods The medicinal herbs were defatted by Et 2O, then extracted by MeOH and determined by HPLC method. Varian C 18 column, mobile phase: MeOH H 2O (15∶85); detection wavelength: 204 nm, flow rate: 0.5 mL/min. Results The content of aucubin and its recovery in three medicinal plants were as follows: aucubin in P. decora, in P. davidii and P. artselaeri were 0.90%, 1.94%, 0.95%; recovery rates were 102.3%, 98.2%, 97.6% in P. artelaeri. Conclusion Medicinal plants of Pedicularis Linn. has a good exploiting prospect, the research can provide the reference for evaluating of these medicinal herbs

BACKGROUND: It is indicated in researches of recent years that both astragalus and angelica act on anti-free radical and protect renal injury due to ischemia / reperfusion.OBJECTIVE: To observe the protection and its mechanism of astragalus and angelica injections on adenosine triphosphate-ase (ATPase) in renal injury due to ischemia/reperfusion.DESIGN: The observing controlled experiment based on experimental animals .SETTING: Physiological teaching & research room and teaching & research room of renal functional protection in a medical college. MATERIALS: The experiment was performed in Physiological Experimental Room of Luzhou Medical College from January 2001 to March 2001. Totally 33 Japanese big-ear white healthy adult rabbits of either sex were employed,provided by Experimental Animal Center of Luzhou Medical College, in the mass of(1.63 + 0. 22) kg. According to random number table, they were divided in sham-operation control(8 rabbits), simple ischemia/reperfusion group (8 rabbits), astragalus injection + ischemia/reperfusion group (astragalus group) (8 rabbits) and angelica injection + ischemia/reperfusion group(angelica group) (9 rabbits).METHODS: One day before operation, on the day of operation and 1 day after operation, successively, intravenous medical injections (astragalus 1.25 g/kg,angelica 12.5 g/kg) were administrated in astragalus and angelica groups everyday respectively, and injection with physiological saline 5 mL/kg was applied in the control and simple ischemia/reperfusion group. In 48 hours reperfusion after 1 hour ischemia in kidney, blood sample was collected from inferior vena cava. The upper tissue of the right kidney was collected and fixed by placed in 30 mL/L glutaraldehyde and the lower tissue was prepared into homogenate. Ultrastructure of renal tissue was examined with electron microscope; serum creatinine level and ATPase activity in renal tissue were assayed.MAIN OUTCOME MEASURES: Ultrastructure of renal tissue, serum creatinine level and ATPase activity in renal tissue.RESULTS: In simple ischemia/reperfusion group, renal tissue was degenerated significantly, and the disorders in astragalus and angelica groups were reduced markedly compared with simple ischemia/reperfusion group. Serum creatinine level in simple ischemia/reperfusion group was higher remarkably than the sham-operation control ( P ＜ 0. 05 ), and that in astragalus and angelica groups was reduced than simple ischemia/reperfusion group (P ＜ 0. 05) . In simple ischemia/reperfusion group, the levels of Mg2+-ATPaes, Na+-K+-ATPase and Ca2+-ATPase were(0. 155 ±0. 020),(0.179±0.018), (0.150±0.022) nkat/g respectively, which was markedly reduced compared with sham-operation control [ (0. 174 + 0. 012),(0. 198 + 0. 012), (0. 181 + 0. 017) nkat/g], ( t = 2. 344, 2. 438, 3. 014,P ＜ 0.05 ). In astragalus and angelica groups, respectively, the activities of Mg2+-ATPaes, Na+-K+-ATPase and Ca2+-ATPase were(0. 172 ± 0. 023),(0. 196 ±0. 077), (0. 175 ±0. 016) and (0. 177 ±0. 015), (0. 200 ±0.011 )and (0. 181 ± 0. 025) nkat/g successively. Except that Mg2+-ATPaes activity in astragalus group was not different significantly from that in simple ischemia/reperfusion group, all the rest were higher than simple ischemia/reperfusion group(t =2. 372 -2. 786, P ＜0.05).CONCLUSION: Both astragalus and angelica inhibit the decrease of ATPase and improve the disturbed local blood-flow adjustment in kidney, which has provided experimental basis of astragalus and angelica on reducing renal injury induced by ischemia/reperfusion through protecting ATPase.

Objective Ventricular remodeling mode after myocardial infarction in rats was used to investigate the effects of recombinant human erythropoietin (rHu-EPO) on hemodynamic,ventricular function and infarct size of left ventricle in rats with myocardial infarction, so as to find out the optimum time and protocol of EPO treatment for ventricular remodeling after myocardial infarction and provide evidence for clinical application of EPO. Methods Sixty healthy male Sprague Dawley rats were divided randomly and equally into 5 groups:sham group,simple cardiac remodeling after myocardial infarction group, the intervention groups of different drugs ( rHu-EPO in the intervention group and SB203580 group,rHu-EPO+SB203580,group) . Ligation was set at more than 1/3 points on the anterior descending coronary artery to make model of myocardial infarction in rats, and the rats were feeded for four weeks. Different drugs in the intervention groups were subcutaneously injected once before ischemia and twice a week after ischemia. Respectively, 24 hours, 2 weeks, and 4 weeks after ischemia, we detected the hemodynamic parameters, recorded the left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), maximal rate of left ventricular pressure (+dp/dt) and left ventricular pressure decline rate (-dp/dt), and recorded the synchronization of heart rate (HR) . The animals were sacrificed 4 weeks after ischemia, and the heart specimens were collected. The relative weight of left and right ventricle (LV/BW in the RV/BW) was calculated according to the left and right ventricular weight (LVW, RVW) . TTC and Evans blue staining was used to detect left ventricular infarct size, and pathological examination was used to observe the gross and microscopic morphological change. Results 24 hours after operation: Compared with the sham group, in simply cardiac remodeling after myocardial infarction group, rats' left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP) and left ventricular pressure maximum rise and fall rate (±dp/dt) was significantly abnormal,LVSP and ± dp/dt were significantly reduced, the LVEDP was significantly increased (P<0.05);compared with simply cardiac remodeling after myocardial infarction group, in the intervention groups (rHu-EPO in the intervention group, SB203580 group, rHu-the EPO + SB203580 group) rats' ± the dp /dt improved significantly (P<0.05) . After 2 weeks:compared with the sham group, in simple cardiac remodeling after myocardial infarction group rats’LVSP and LVEDP and ± dp/dt significant deterioration (P<0.05) ;compared with simply cardiac remodeling after myocardial infarction group, in the intervention group (rHu-EPO in the intervention group, SB203580 group, rHu-the EPO+SB203580 group) rats’± the dp/dt was significantly improved (P<0.05) . After 4 weeks:compared with the sham group, in simple cardiac remodeling after myocardial infarction group rats’LVSP and LVEDP and ± dp/dt significant deterioration (P<0.05) ; compared with simply cardiac remodeling after myocardial infarction group, in the intervention groups (rHu-EPO in the intervention group, SB203580 group, rHu-the EPO + SB203580 group) rats' ± the dp/dt was significantly improved (P<0.05) . Compared with the sham group, in simply cardiac remodeling after myocardial infarction group rats' LV/BW increased, the difference was statistically significant (P<0.05) . Compared with simply cardiac remodeling after myocardial infarction group,in the intervention group (rHu-EPO in the intervention group and SB203580 group, rHu-the EPO+SB203580 group) rats’LV/BW decreased, the difference was statistically significant (P<0.05 ) . Compared with simply after myocardial infarction cardiac remodeling group, in the intervention groups (rHu-EPO in the intervention group and SB203580 group,rHu-EPO+SB203580 group) rats’cardiac infarct size was significantly reduced (P<0.05). Conclusions rH-EPO can protect the heart function through improving the left ventricular systolic and diastolic function after AMI in rats.RH-EPO can suppress ventricular remodeling, through reducing ventricular relative weight and infarct size and promoting the renewal of capillary in infarction area after AMI in rats.

Objective To investigate the prognosis correlation factors of sudden hearing loss.Methods A retrospective analysis was performed in 137 cases (149 ears) of sudden hearing loss.The relationships between the age,prehospital delay time,type of hearing loss,degree of hearing loss,and whether with dizziness,tinnitus,diabetes mellitus,high blood pressure and therapeutic effect were observed.Results The total effective rates in ＜ 45 years,45-59 years and ＞ 59 years patients were 86.36％(38/44),77.78％ (56/72) and 57.58％ (19/33) respectively.There were statistical differences in the total effective rate between ＜ 45 years,45-59 years patients and ＞ 59 years patients (x2 =8.128,P =0.004; x2 =4.525,P =0.033).The total effective rates in patients who were treated ≤7 d,8-14 d and ≥ 15 d were 83.52％ (76/91),76.67％(23/30) and 50.00％(14/28) respectively.There were statistical differences in the total effective rate between patients who treated ≤7 d,8-14 d and patients who were treated ≥ 15 d (x2 =13.050,P =0.000; x2 =4.459,P =0.035).The total effective rates in low-mid frequency type,all frequency type,total deafness type and mid-high frequency type were 89.66％ (52/58),84.44％ (38/45),7/12,47.06％ (16/34) respectively.There were statistical differences in the total effective rate between low-mid frequency,all frequency type and total deafness type,mid-high frequency type (P ＜ 0.05).The total effective rates in hearing loss mild degree,middle degree,severe degree,extremely severe degree and total deafness were 87.23％ (41/47),86.11％ (31/36),61.90％ (13/21),7/15 respectively.There were statistical differences in the total effective rate between mild degree,middle degree and severe degree,extremely severe degree and total deafness (P ＜ 0.05).The hearing loss prognosis with the dizziness,diabetes mellitus,high blood pressure was worse.Conclusions It is considered that the age,prehospital delay time,type of hearing loss,degree of hearing loss,and whether with dizziness,high blood pressure,diabetes mellitus are related to the total effective rate.The prognosis of hearing loss can be estimated according to these correlation factors.

Clinical teaching plays an important role in the education of medical graduate students.In the clinical teaching of the graduate students of burn and plastic surgery,we based it on clinical practice and guided the students in changing their modes of learning and thinking from examination-orientedness to problem solving,from simple vertical to clinical lateral thinking.We made sure that they all acquired innovative ideas and correct methods of clinical research by various academic activities,and cultivated their practical abilities and medical virtues by strict training and moral education.