Objective To building a kind of system emergency management of nursing. Meth-ods Analyized the hazardous, made out related plans and trained staff according to the Joint commission international accreditation standards for hospital, and then elvaluated the effects of it. Results All kinds of risks in the hospital about emergency management were decreased, the ability of nursing department to defect the emergencies enhanced obviously. Conclusions JCI could help hospital practise the scientific, standarized, ordered and detailed nursing emergency management, which can guarantee a kind of safety en-vironment for patients, their family and staff of hopital.

Objective To compared intensity modulated radiation therapy (IMRT) with conventional radiotherapy(CR) for the left side breast cancer after breast-conserving surgery in regard to the homogeneity of dose in the target area, cardiac dose and irradiation volume in the target area. Methods Thirty-eight patients received inverse planning of IMRT with dynamic multi-leaf collimation (dMLC). Prescription dose was 46Gy in breast volume with X-ray, and added electron boost dose was 14Gy in the tumor bed, with a total dose of 60Gy. Clinical target volume(CTV) and heart were evaluated with dose-volume histograms(DVH) in the two plans, with the t test taken with SPSS 11.0. Results Average received dose of 95% breast volume(D 95) was (4541?34),(4517?62)cGy, volume of 105% of dose prescription(V 105%) was 17.5%?17.6%,29.4%?26.3%, while V 110% was 0.3%?0.8%,3.7%?8.2% with IMRT and CR, respectively. Received 30Gy by the heart(V 30) was 4.6%?4.3%,18.8%?12.2%(P

Objective To explore the method for early diagnosis of masked polycythemia vera (mPV) by comparing and analyzing the features of mPV and polycythemia vera (PV). Methods A total of 200 newly diagnosed male patients were collected based on diagnostic criteria, including 100 cases of PV and 100 cases of mPV. Erythropoietin (EPO), neutrophil alkaline phosphatase (NAP) score, bone marrow biopsy (BMB), and JAK2 V617F mutation were evaluated in all cases. After 6 months, hemoglobin (Hb) and JAK2 V617F mutation load were detected in patients without special treatment in two groups during follow-up. Results EPO, NAP score, BMB hematopoietic volume and the number of megakaryocyte had no statistical differences between PV group and mPV group [(3.4 ± 0.7) U/ml vs. (3.2±0.6) U/ml, (276±20) score vs. (278±21) score, (78±10) % vs. (76±9) %, (53±6) vs. (51±5), respectively], while JAK2 V617F mutation load in PV group was higher than that in mPV group[(89.2±9.4) % vs. (78.1±8.6) %, P<0.05]. In mPV patients without special treatment, Hb ≥185 g/L was found in 37 patients after 6 months, and the level of Hb and JAK2 V617F mutation load in these 37 patients reached (194±8) g/L and (90.7±9.1) %, respectively. Conclusions There is no significant difference in EPO, NAP score and BMB between PV and mPV, but the JAK2 V617F mutation load is different. In mPV patients without special treatment, Hb level can reach the typical PV diagnostic criteria after 6 months, meanwhile, JAK2 V617F mutation load is also increased.

This paper arranged the research results of the chemi-cal components and pharmacological effects of five kinds of Loni-cera. All these herbs have organic acids( chlorogenic acid) , fla-vonoids( galuteolin) , triterpenoid saponins, iridoids and volatile oils, and have antibacterial, antiviral, anti-inflammatory, an-tioxidant, hepatoprotective, immunological effects, and so on.The major medicinal ingredients and pharmacological effects of these herbs have no significant difference. Some similar pharma-cological effects are caused by different chemical components.

Objective To study the diagnostic value of coronary disease with 16-slice spiral CT.Methods 35 patients with coronary heart disease(CHD) were divided into two groups according to the risk rate of CHD:group 1 with acute coronary artery syndrome(ACS)(including acute myocardial infarction,AMI;unstable angina,UA);group 2 with stable angina(SA).They were studied by 16-slice spiral CT(retrospectively ECG-gating,0.5 s ratation),the images were reconstructed by survey methods to display the coronary artery atherosclerosis plaques,then to evaluate the nature of plaques by detecting CT value of plaque(using the standard of the CT value of the coronary artery atherosclerosis plaque of Schroeder)and to analyze the degree of the stenosis of coronary artery caused by the different type of plaque.Results There were 19 soft plaqes,11 middle plaques and 7 calcification plaques in ACS group;3 soft plaqes,3 middle plaques and 11 calcification plaques in SA group.There was a positive relation between soft plaqes and middle plaques with the risk rate of CHD,especially soft plaque(P

Objective To analyze the dosimetfic benefits, clinical effect and side-respond of whole breast using intensity modulated radiotherapy for early breast cancer after conservative surgery. Methods From Oct.2004 to Aug. 2005,103 patients received the whole breast intensity modulated radiation therapy (IMRT). A dosimetric comparison of IMRT with conventional radiotherapy (CR) was performed on each patient. The cosmetic results, clinical effect and side-respond were observed. Results The average volume proportion of 95% and 107% prescribed dose was 95.8% ± 4.90% and 84.0% ± 20.7% (t = 9.60, P < 0.01) with IMRT and CR in clinical target volume, respectively. The V20 (lung volume of aceepted> 20 Gy/all lung volume × 100%) of the ipsilateral lung were 15.70% ± 4.64% and 23. 11% ± 7.88% (t = - 13.3, P < 0.01). The V30of the heart were 4.44% ±3.93% and 15.55% ± 10.89%(t = - 11.3, P< 0.01) with IMRT and CR respectively for sixty-three left side breast cancer patients. The 1- and 2-year excellent rate of good cosmetic outcome was both 100%. The 1-, 2- and 3-year local control rate was 99% ,99% and 98% ,respectively. The 1-, 2- and 3-year disease-free survival rate was 99% ,99% and 96% ,respectively. The Grade 1 and 2 acute radiation skin reaction rate was 95.1% and 4.9%, respectively. Conclusion Compared with conventional radiotherapy, IMRT improves dose distribution of CTV and reduce the dose of normal tissue around CTV;but with better clinical effects and lower side-respond for early breast cancer patients after breast conservative surgery.

Objective Colorectal polyp is a precancerous lesion of colorectal cancer .Aim of the study was to explore the risk fac-tors of colorectal polyp malignant transformation .Methods The related information of 75 084 colonoscopies performed from 2003 to 2012 in Southwest Hospital in Chongqing were collected and the relationship between polyp malignant transformation and the pa-tient age ,sex ,polyp location ,size or histological types was analyzed .Results From 2003 to 2012 ,polyps were diagnosed in 14 806 cases of the total 75 084 patients with a 19 .72% detection rate .There were significant difference of the left-side and right-side pol-yp detection rate in different age groups ,and the frequency of polyps distributed in the whole colorectum increased with the increase of age .The rates of epithelial neoplasia and malignant transformation increased with age .At the same time ,malignant transforma-tion rate was significant higher in polyps located in left-side than that in right-side (P<0 .0167) ,in adenoma than that in inflamma-tory hyperplastic polyp (P<0 .01) .The larger diameter and the more villus ,the higher rate of malignant transformation .Conclusion Patient age ,polyp size ,location and histological type could be considered as the significant predictors of colorectal polyp malignant transformation .It may be useful to treat the polyp with endoscopy in patient with age more than 45 and adenoma whose diameter was not less than 1 cm ,located in left-side for prevention of colorectal cancer .

Objective To study the correlation between sleep quality and anxiety in patients with chronic kidney diseases (CKD).Method Toally 118 patients with CKD were investigated with Pittsburgh sleep quality index (PSQI) and self-rating anxiety scale (SAS).Results About 75.42％ (89/118) patients had poor quality of sleep.The scores by PSQI and the dimensions were higher than those of the norms (all P＜0.05),but the total scores by PSQI and the factors of sleep quality,time of falling sleep,duration of sleep,use of hypnosis drugs were all significantly lower than those of the insomnia group (all P＜0.01).35.59％ (42/118) of the patients had anxiety and the score of SAS was significantly higher than that of the national norm (P＜0.01).The total scores of PSQI,sleep quality,sleep time,sleeping time,sleep disorder,daytime function were positively related to the score of SAS (P＜0.01).Conclusions The quality of sleep is poor in the CKD patients and there is a positive correlation between the quality of sleep and the anxiety.It is necessary to strengthen the knowledge-related health education and to provide emotional support and individualized nursing services for CKD patients so as to relieve their anxiety and improve their sleep quality.

Aim To investigate the effect of Salvianol-ic acid A (Sal A)on mice with isoproterenol (ISO)-induced myocardial infraction and its possible mecha-nisms.Methods The mice were subcutaneously in-jected with ISO (8 mg·kg-1 )to induce myocardial in-farction.The myocardial protective effect of Salvianolic acid A was evaluated from mortality rate,electrocardio-gram (ECG),heart function,myocardial infarction in-dex,serum myocardial enzymes and its action mecha-nisms were explored from inflammation,anti-oxidation and cells apoptosis.Results Salvianolic acid A dose-dependently enhanced the heart function of myocardial infarction mice,reduced the heart index,inhibited the myocardial enzyme leakage,showed obvious myocardi-al protection effects.ELISA results showed that Salvi-
anolic acid A could reduce the expression of myocardial inflammatory cytokines such as IL-6(interleukin-6,IL-6),TNF-α(tumornecrosis factor-α,TNF-α).West-ern-blotting confirmed that Salvianolic acid A could in-crease the expression of anti-apoptotic proteins Bcl-2, reduce the expression of apoptosis protein Bax,and raise the phosphorylation level of PI3K and Akt.Con-clusion Salvianolic acid A displays a significant pro-tective effect against isoproterenol-induced myocardial infarction and its mechanism may be related to the in-crease of PI3K/Akt signal pathway and the inhibition of cell apoptosis and inflammatory reaction.

Objective To study the effect of Punica granatum( pomegranate) see d oil( PSO) on proliferation and apop-tosis behaviors of breast cancer cells.Methods Fatty acid composition was detected by gas chromatography,breast cancer cells, MCF-7 and MDA-MB-231 were treated with PSO, cell proliferation was observed by MMT, cell apoptosis was analyzed by flow cytometry,and expression levels of proliferation and apoptosis-related proteins were detected by Western blot.Results Punicic acid (PA) was the major fatty acid in PSO(74.41%).PSO could inhibit the proliferation while in-ducing apoptosis in both cell lines in a dose-and time-dependent manner, significantly decrease the expression level of Cox-2 and Bcl-2, increase the expression level of Bax and caspase-3 (cleaved),remarkably upregulate the expression of P53 in MCF-7, and downregulate p53 expression in MDA-MB-231.Conclusion PA may be one of the functional ingredients of PSO which can inhibit proliferation and induce apoptosis in breast cancer cells.These effects are probably mediated by regu-lating the expression of Cox-2, Bcl-2, Bax, caspase-3 (cleaved) and p53.