Objective To investigate the clinical outcomes of alprostadil in prevention of portal vein thrombosis after splenectomy and devascularization.Methods 113 patients with PHT who were treated with prophylactic alprostadil after splenectomy and devascularization procedures from May 2009 to Apr 2013 were included into the treatment group.112 conservative patients with PHT who were treated with traditional prophylactic anticoagulants after the same operations before May 2009 were included as the control group.The postoperative complication rates,mortality,postoperative drainage volume from the abdominal cavity,blood platelet counts,prothrombin time,liver function,Child-Pugh's scores and portal vein thrombosis rates between the two groups were compared.Results When compared with the control group,the postoperative complication rate and mortality in the alprostadil group were not increased,while the postoperative drainage volume from the abdominal cavity was significantly reduced.The increase in blood platelet counts and prothrombin time were similar in the 2 groups.Furthermore,the extent of hepatic dysfunction on the 3rd and 7th after operation was significantly decreased.On short term follow-up,color droppler ultrasonography showed the portal vein thrombosis rate of the treatment group was significantly lower than the control group,with less extensive degree of thrombosis in the treatment group.Conclusion Alprostadil is a safe and effective anticoagulant which provided better prevention of portal vein thrombosis after splenectomy combined with devascularization.

Objective To investigate the impact of health education and standard treatments on the life quality of asthmatic children.Methods We conducted clinic treatments of 110 cases of asthmatic children lasting for 6 months,which were divided into standard treatment and health education group with 60 cases and group without standard treatment and health education with 50 cases.We emphasized the education management on cases in experimental group,which strictly obeyed the Global Initiative for Asthma (GINA) to formulate classified treatments as well as regular follow-up.Control group received the same treatments as experimental group yet without emphasizing health education about asthma on parents,which was accompanied with irregular follow-up.We compared the before-treatment and after-treatment life-quality and lung functions of asthmatic children.Moreover,we used Pediatric Asthma Quality of Life Questionnaire (PAQLQ) to evaluate the before-treatment and after-treatment life quality of asthmatic children.Results After follow-up lasting for 6 months,the treatments of experiment group had obvious improvements (P ＜0.01).The improvements of peak expiratory flow (PEF) of lung function test and timed vital capacity of the first second (FEV1) of experimental group were also better than the improvements of these two metrics of control group (P ＜ 0.01).In addition,after 6 months,in both all dimensions of PAQLQ and total score,the differences between before and after treatment of experimental group were significant (P ＜ 0.01,P ＜ 0.05) ; and the differences between experimental group and control group were also significant in both all dimensions of PAQLQ score (12.4 ±2.1) and total score comparing to the control group (8.1 ±2.3),and the differences are also significant (t =2.5,P ＜ 0.01).Conclusions Health education and standard treatments significantly improved the life quality of asthmatic children with a good compliance of treatment and a low recurrence rate,which is worth of popularizing.

Pancreatic sinistral portal hypertension is a localized kind of portal hypertension that usually occurs as a result of the splenic vein obstruction caused by pancreatic diseases.Furthermore,it is also an important cause of upper gastrointestinal hemorrhage.Management in clinical practice should be directed at the sinistral portal hypertension and primary pancreatic diseases.

Objective To study the relationship of apoptosis-related gene Survivin with Bcl-2,Bax protein in adenomyosis.Methods The expressions of Survivin,Bcl-2 and Bax protein were deteeted by immunohistochemical method(SP)in ectopic and eutopic endometrium of adenomyosis from 46 cases,and compared with that in eutopic endometrium from endometrium 30 cases without adenomyosis.Results The expression rate of Survivin protein in ectopic endometrium of adenomyosis was much higher than that in normal endometrial cells.The Survivin was positively corelated to Bcl-2,negatively to Bax.Conclusion Survivin may play an important role in pathogenesis of adenomyosis.With Survivin gene,apoptosis-related gene Bcl-2 may have a synergic role and Bax have an antagonistic role in the formation and progression of adenomyosis.

Objective To investigate the changes of leukocyte derived cytokines,IL 1?,IL 6,IL 8,and TNF ?,in platelets concentrates (PCs) during storage,and to study the effect of leukodepletion on cytokine concentration in PCs and the incidence rate of febrile non hemolytic transfusion reaction (FNHTR).Methods 8 bags of apheresed PCs from 8 voluntary donors were each divided into two identical portions (A and B).Group A underwent leukocyte filtration,while group B did not.Then both groups were stored at 22℃ for 5 days.The levels of cytokines (pg/ml),white blood cell (WBC) count and platelet count in both groups were tested on the day 0,3 and 5 during storage.In clinic,240 patients were randomly divided into two groups with 120 in each group to receive non filtered or filtered PCs (1 bag/patient).The incidence of FNHTR was investigated.Paired t test and ? 2 test were used in data analysis. Results There was a significant positive correlation between the content of WBC in PCs and the level of cytokines.On the 5th day of storage,residual WBC in leukoreduced PCs were less than 1?10 6/PC,the levels of cytokines remained the same as those on 0;however,WBC in non filtered PCs was (351?81)?10 6/PC,and the levels of IL 1??IL 6?IL 8 and TNF ? were 105.0pg/ml,269.0pg/ml,1840pg/ml and 42.0pg/ml respectively and increased 18 ( P

Objective To investigate the effects of different concentrations of sevoflurane on proliferation and invasion in human prostate cancer PC3 cell line. Methods The cells were randomly divided into four groups:control group and three sevoflurane groups (exposed to 1.7%, 3.4%and 5.1%sevollurane for 2, 4 and 6 h respectively). The ability of prolifera-tion and invasion of PC3 cells were evaluated by MTT and Transwell invasion assays. Western blot analysis was performed to detect the protein expression of hypoxia inducing factor 1 alpha (HIF-1α) in PC3 cells. Results The ability of proliferation and invasion of PC3 cells was significantly increased after being exposed to sevollurane for 2, 4 and 6 h (P<0.05), and the expression of HIF-1αprotein in PC3 cells was significantly higher after being exposed to sevollurane for 2,4 and 6 h (P<0.05), showing the Treat 3 group>Treat 2 group>Treat 1 group (P<0.05). Conclusion Sevoflurane can promote prolifer-ation and invasion in PC3 cells, which are gradually increased with time and concentration of sevoflurane treatment. The mechanism may involve in the up-regulation of HIF-1αexpression.

Objective:To probe the implement of inquiry -based teaching in nursing ethics. Method:105 nursing students attended the innovation of inquiry-based teaching for Nursing Ethics. Results:88. 5% nursing students satisfied with innovation of teaching;82 . 9% nursing studentsethics awareness was enhanced largely in understanding for nursing ethics;68 . 6% nursing students considered that their ability for ethical thinking has been enhanced largely;93 . 3% nurs-ing students thought that nursing ethics was important. Different inquiry methods for nursing students led to different level of analysis ability for ethic cases(P﹤0. 001). Conclusions:It's necessary to perform the innovation of inquiry-based teaching, promoting the student's activity, focus on learning process and enhancing the students comprehensive ability.

Objective To investigate the accuracy of prognosis risk assessment and clinical applicability of Rockall (RS) and Blatchford scoring system (BRS) for acute nonvariceal upper gastrointestinal bleeding (ANVUGIB). Methods From January 2009 to December 2009, the clinical date 195 ANVUGIB patients who met the standards with complete information and treated in The First Affiliated Hospital of Anhui Medical University were recorded. Each patient's scores of RS and BRS were calculated for risk stratification. Patients were followed up for 30 days after discharged.Death or the prognosis of disease in 30 days after discharged was considered as clinical study endpoints.Checked prognostic capacity of these two scoring system. Results In the 195 patients, there were 150 years, mean age was 53.97±18.34 years. 90 patients' age was over sixty (elderly group), 105 less than sixty (non-elderly group). 182 patients survived (93.3%), while 13 dead (6.7%). In survival patients, 11were re-bleeding (5.6 %). Mortality ( 12.2 %, 11/90), the percentage of patients with comorbidities (43.3%, 39/90) and taking aspirin (24. 4%, 22/90) were higher in elderly patients than non-elderly patients (1.9%, 2/105; 16.2%, 17/105; 11.4%, 12/105 respectively)(P＜0.05).The AUC of RS in predicting risk of death was 0.742 (P=0.004) and re-bleeding was 0.469 (P=0.101). For BRS score system, the AUC of predicting risk of death was 0. 493 (P= 0. 067)and rebleeding was 0.341(P=0.092). The RS score was positively correlated with length of hospital stay,however there was no statistically significant between BRS score and length of hospital stay.Conclusion RS score system was good at predicting the risk of death, and the score was positively correlated with length of hospital stay. While it was poor in predicting the risk of re-bleeding. BRS performed poorly in predicting the risk of both death and re-bleeding, so it was not suitable for predicting the risk of hospitalized patients.

Objective The study aimed at establishing an evaluation index system of clinical competence of nursing undergraduate interns,which is more scientific,clearly guidable,comparative and convenient in order to provide the theoretical foundations to enhance the standardization,objectivity and fairness of the evaluation of clinical competence of nursing undergraduate interns.Methods Based on the Delphi method,the items of evaluation system was selected,the standards with 4 different levels for each item were set.Results The evaluation index system of clinical competence of nursing undergraduate interns was constructed,which was composed of 23 items from 5 domains including professional value,clinical nursing competence,communication and collaboration competence,teaching and management competence and professional development competence.Four different levels of evaluation standards were set for each item to differentiate different levels of clinical competence.The enthusiasm coefficient of experts was 96.2％(＞60％),the average authority coefficient of experts was 0.9128 (＞0.70).The harmonization coefficient of the 5 domains in the first grade index was 0.9262 and those of 23 items in the second grade index was 0.9127.Conclusions The index system of clinical competence of nursing undergraduate interns established evaluation standard of each level.The enthusiasm coefficient,authority coefficient and harmonization coefficient of expert consultation showed that it has high representativeness and reliability.

ObjectiveTo investigate the risk factors of metabolic syndrome ( MS ) in obese subjects.Methods A seven-year follow-up study was conducted in 413 simple obese subjects and 196 subjects with normal body weight who were recruited from community residents during physical examination in 2000.There was a 7 years follow-up.Anthropometrics,blood pressure,lipid profile,fasting blood glucose,and 2 h blood glucose after glucose loading were measured.Endothelium-dependent dilatation (EDD) test was also performed.Results Among 553 of 609 subjects who were followed up in 2007,there were 381 simple obese subjects ( simple obese group) and 172 normal weight subjects( normal weight group).Seven-year cumulative incidence of MS was 35.17％ in simple obese group and 8.14％ in normal weight group.In simple obese group,subjects with MS showed greater or higher levels of waist circumference( WC ),waist-hip ratio ( WHR ),triglyceride ( TG ),fasting plasma glucose ( FPG ),fasting insulin (FINS),and homeostasis model assessment for insulin resistance index (HOMA-IR) (all P＜0.05 ),and also decreased EDD( P＜0.05 ) as compared with those without MS.WC,WHR,and FINS were higher( all P＜0.05 ) and EDD was lower( P＜0.05 ) in subjects with MS of normal weight group than those without MS.Logistic analysis showed that the male gender,WC,WHR,FPG,HOMA-IR,and EDD were major risk factors of MS.Conclusion Central obesity,insulin resistance,and endothelial dysfunction are important independent risk factors for development of MS.