Objective To compare postoperative pulmonary infection in patients undergoing surgical operation at different surgical opportunities.Methods Patients who underwent surgical operation in a hospital from January to December 2014 were surveyed retrospectively,patients' data were reviewed,patients with postoperative pulmonary infection were compared.Results A total of 20 343 surgical patients were investigated,227(1.12％) had postoperative pulmonary infection.Postoperative pulmonary infection rate in patients undergoing emergency operation was higher than that of selective operation (5.13 ％ vs 0.70 ％,x2 =307.49,P＜0.001).Postoperative pulmonary infection rates in patients undergoing emergency neurosurgical,general surgical,and cardiothoracic surgical operation were all higher than selective operation (all P ＜ 0.001).Among patients with pulmonary infection following emergency operation,the proportion of those who aged ＜60 years,with preoperative irrational antimicrobial use,cardiovascular disease,hypertension,and tracheotomy were all higher than those who received selective operation (all P＜0.05);the proportion of patients with cancer is lower than that of elective surgery patients(P＜0.05).Conclusion Postoperative pulmonary infection rate in patients undergoing emergency operation is higher than selective operation,postoperative pulmonary infection rates in patients undergoing emergency neurosurgical,general surgical,and cardiothoracic surgical operation are high.Patients with cardiovascular disease and hypertension are the focus of protection;for elective surgery,cancer patients are the focus of protection.

Objective To investigate the safety of argon plasma coagulation (APC) with submucosal injection for colon polyps.Methods A total of 30 sets of fresh sigmoid colon from healthy pigs were assigned to control group to receive direct APC,and to treatment group to receive APC with submucosal injection,respectively.After same time and energy of APC,each specimen was sampled for pathological evaluation and the damage extent was determined as mucosa,submucosa (superior 1/3,middle1/3,inferior 1/3),and muscularis propria.Ten cases of colon sessile polyps with diameter of about 1-2 cm,elevated within 3mm by endoscopic ultrasonography(EUS).Direct APC or APC with submucosal injection were performed,respectively,and the difference was observed by EUS.Results In 30 cases of control group,the injury depth of 5 cases reached to the muscularis propria and of 25 cases to submucosa layer,among which 4 cases showed damage to superior submucosa 12 middle submucosa and 9 inferior submucosa.In 30 cases of treatment group,there was no damage to muscularis propria.The injury depth of 26 cases reached submucosa layer,among which 22 cases showed damage to superior submucosa,4 middle submucosa.The results showed significant difference between two groups (P ＜0.01).In patients who underwent APC with submucosal injection,EUS showed effective isolation of mucosa and muscularis propria.It confined the injury to the mucosal layer.Without treatment of submucosal injection in advance,it seemed easier to damage the submucosa and muscularis propria.Conclusion Submucosal injection can protect the colon injured by APC,and may reduce the risk of colon perforation by APC for colon polyps.

Objective To investigate the risk fairs and significance of late recurrence in non-small cell lung cancer (NSCLC)patients who had undergone complete resection and remained recurrence-free for5 years.Methods 496 individuals diagnosed and surgically treated for Stage Ⅰ and Ⅱ A NSCLC were included.We examined patients at 3-month intervals for the first 2 years after surgery and typically at 6-month intervals thereafter on an outpatient basis.The follow-up evaluation included physical examination,inaging examination and tumor narkers.Pathological examination had also been performed when needed.Of these,336 patients remained recurrence-free for 5 years were followed up continuously for 3 years.Clinicopathologic factors were collected including age,sex,smoking history,preoperative serum carcinoembryonic antigen (CEA) level,surgical apprach,maximum tumor dimension on resected specimen,histologic type,histologic differentiation,intratumoral lymphatic permeation,intratumoral vascular invasion,pleural invasion and pathologic stage.The primary end event was lung cancer recurrence.The data collection ended in January 2011.Kaplan-Meier method was used for survival rate.Survival difference wasevaluated bylog-rank test.Multivariate Cox regression was used to test the relationship of recurrence-free probability to various clinicopathologic factors.Results At 5 years after resection,109 patients had died of disease and 33 had died of other causes.18 patients were alive with disease.The remaining 3 - 36 patients were alive and recurrence-free for the first 5 years.The median follow-up period of these 5-year recurrence free survivors was 27 months (range,3-36 months).34 (10.1％)patients developed a late recurrence at 3 years among the 336 patients.Recurrence was locoregional in 13 (38.2％)patients:6 patients in mediastinal lymph nodes,3 patients in ipsilateral lung,2 patients with pleural dissemination and 2 patients in other locations.Recurrence was distant in 21 (61.8％) patients:8 patients with multiple-organ metastases,13 patients with single-organ metastasis,and the latter consisted of 5 patients in contralateral lung,3 patients in liver,2 patients in central nervous system and 3 patients in other locations.Smoking history,preoperative serum CEA level,histologic differentiation,intratumoral lymphatic invasion,intratumoral vascular invasion,pleural invasion and pathologic stage were risk factors for late recurrence in univariate analysis.Multivariate Cox analysis demonstrated that intratumoral vascular invasion and intratumoral lymphatic invasion were independent risk factors for late recurrence.Conclusion NSCLC patients have a significant risk of late recurrence after complete resection 5 years,especially for the patients with intratumoral vascular invasion and intralumoral lymphatic invasion.It is needed and significant for the patients to follow up continuously after 5 years of complete resection.

Objective To explore the effect of ultra-early hyperbaric oxygenation (HBO) on bone calcium, biomechanical properties and bone collagen of femur in rats with complete spinal cord transaction. Methods A total of 75 Sprague-Dawley rats were randomly divided in-to sham group (n=15), model group (n=20) and HBO group (n=40). HBO group was divided into three hours group (HBO1 group, n=20) and twelve hours group (HBO2 group, n=20). All groups underwent laminectomy at T10, while the model group, HBO1 group and HBO2 group underwent complete spinal cord transection at the same level. Three hours and twelve hours after surgery, HBO1 group and HBO2 group received HBO, respectively, for three courses with ten days in a course. After treatment, the femoral biomechanical properties, bone calcium and hydroxyproline (Hyp) were determined. The morphology of bone trabecula and the bone collagen was observed with HE stain-ing and Masson triad color staining, respectively. Results After treatment, compared with the sham group, the femoral biomechanical proper-ties, the content of bone calcium and Hyp decreased in the model group (P<0.05);compared with the model group and HBO2 group, they in-creased in HBO1 group (P<0.05). The number of bone trabecula and the bone collagen decreased, and derangement and sparseness were ob-served in the model group;however, the changes were substantially mild in HBO1 group. Conclusion Ultra-early HBO could increase the content of bone calcium and Hyp of femur, improve the morphology of the femur bone collagen, and improve the femoral biomechanical properties in rats with complete spinal cord transection.

Objective To construct an objective,comprehensive core competence evaluation index system for nursing postgraduates,and to provide evidence for postgraduates nursing education.Methods According to literature review,expert interviews,focus group discussions,Delphi and other research methods,we conducted two rounds of 32 experts consultation in 18 cities from 10 provinces to establish the final core competence evaluation index system.Results The two experts consultation derived core competence evaluation index system including 7 level-1 indexes,20 level-2 indexes and 53 entries.Level-1 indexes:theoretical knowledge and skills,critical thinking ability,research ability,clinical care ability,teaching skills,interpersonal communication skills,professional development skills.Conclusions This program is rigorous and reliable,with some theoretical and practical significance of its results,which provide a reference for the training program,evaluation of the quality,assessment of postgraduate nursing education.

Objective The aim of this study was to evaluate the benefits of i.v. iron therapy in iron-defi-cient patients with left ventricular ejection fraction preserved heart failure (HFpEF). Methods 61 HFpEF pa-tients with iron deficiency were randomized to treatment with or without i.v. iron,as ferric carboxymaltose(FCM, n = 31)or placebo(saline,n = 29)for 24 weeks of a double-blind,placebo-controlled trial. The primary end-point was the change in 6-min-walk-test(6MWT)distance from baseline to Week 24. Secondary end-points includ-ed changes in New York Heart Association(NYHA)class,health-related quality of life(QoL),with NT-proBNP under observation. Results Compared with the control group at week 16 and 24,the iron treatment group has much more improve in 6MWT and the health-related quality of life(HRQoL)(P<0.05). The changes in NT-proB-NP level and NYHA heart function classification only show significance at week 24(P<0.05)but not at week 16 (P>0.05). Conclusion In this study,Treatment with intravenous ferric carboxymaltose can improve symptoms, functional capacity,and quality of life.

The education of postgraduate nursing is the highest level in nursing education system.Innovative capability cultivation is the core of postgraduate nursing education,as well as an important measurement index of education quality.How to reform and innovate teaching methods and foster highly specialized clinical talents based on their characteristics has been the focus of attention and exploration.This article aims to explore the methods of innovative talent cultivation of postgraduate nursing from the following several aspects about constructing innovative curriculum system,creating first-class tutor team,promoting scientific research ability,forming innovative postgraduate cultivation pattern and intensifying the scholarly communication.

This in vitro study demonstrated that taurine supplemented culture medium enhanced alkaline phosphatase (ALP) activity, osteocalcin secretion and mineralized matrix formation. Taurine induced activation of ERKI/2 and osteoblast differentiation, which was blocked by pretreatment of osteoblasts with ERKI/2 inhibitor (PD98059), suggesting taurine stimulated osteoblast differentiation via ERKI/2.

OBJECTIVE To investigate the nuclear proteomes in mitochondrial DNA (mtDNA)-depleted A549 cells (Rho0 cells) and their parental cells (Rho+ cells),and to learn more about the nuclear responses to mitochondrial dysfunction.METHODS The nuclear proteomes of Rho and Rho + cells were characterized by two dimensional electrophoresis (2-DE) and SELDI-TOF ProteinChip technologies,the differentially expressed protein- spots were identified by MALDI-TOF mass spectrum (MS),the nucleophosmin and P53 expression were detected by Western blotting assay,and the mitochondrial memhrane potential (MMP) was measured by the laser scanning confocal microscope.RESULTS 2-DE results showed 11 protein-spots were down-regulated and 21 protein-spots were up-regulated in Rho0 cell nuclei.SELDI-TOF MS analysis with NP20 ProteinChips revealed 4 protein-peaks decreased in Rho0 cell nuclei.One down-regulated protein-spot was identified as elF-6,and 4 up-regulated proteinspots were identified as nucleophosmin,SFRS1,SFRS3 and hnRNP G,respectively.The increased expression of nucleophosmin in Rho0 cells was verified by Western blotting.Based on the clues from proteomic analysis,P53 expression in Rho0 cells was higher than in Rho + cells,and MMP was consistent in Rho + and Rho0 cells.CONCLUSION mtDNA-depletion induces nuclear proteome alteration.Rho0 cells can be used as a model to study the crosstalk between mitochondrion and nucleus.

short peptide AS1 screened from the phage random peptide library of 12 amino acids has antigenicity and can react with sera of AS patients. These findings indicate that AS1 could be one of candidate molecules of AS-specific serum markers.