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

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 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.

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 To observe quantitatively the optic radiation alterations in chronic Leber's hereditary optic neuropathy (LHON) using MR diffusion tensor imaging at 3.0 T.Methods Twenty-five patients with chronic LHON and twenty-eight sex-and age-matched disease-free control subjects wereenrolled from March 2011 to December 2014.The whole brain DTI examination and retinal opticalcoherence tomography were performed in all the subjects.The parameters values of optic radiation includingfractional anisotropy(FA),mean diffusivity(MD),principal eigenvalue(λ//),orthogonal eigenvalue(λ⊥) and average retinal nerve fiber layer (RNFL) thickness and temporal retinal nerve fiber layer(RNFL) thickness were measured.For DTI and OCT parameters,differences between patients and controls and differences right and left of the patient group were evaluated using independent-samples t test and paired t test respectively.Results In LHON patients,the DEC maps showed that the bilateral optic radiation fibers were obviously sparse and slender.The values of FA,MD,λ// and λ⊥ in the right optic radiation were 0.523±0.050,(0.903±0.061) × 10-9 mm2/s,(4.999 ±-0.097) × 10-9 mm2/s and (4.126-± 0.065) × 10-9 mm2/s respectively,and the corresponding values of left optic radiation were 0.537±0.041,(1.057±0.573)× 10-9 mm2/s,(5.052±0.119)×10-9 mm2/s and (4.138±0.072)×1009 mm2/s.Compared with optic radiation in the control group,the bilateral FA was significant reduced,the bilateral λ⊥ value and right MD value were significant increased (t=-6.524,-6.045,6.932,6.454,3.471,P＜0.05).However,there were no significant difference of the bilateral λ〃 and left MD (t=-0.457,1.221,1.833,P＞0.05).There were no significant differences in FA,MD,λ//and λ⊥ between the left and right eyes in LHON patients(P＞0.05).The values of average RNFL thickness and temporal RNFL thickness in right eyes were (59.36± 10.94) and (41.72±9.43) μm respectively,and the corresponding values of left eyes were (60.12±9.81),(44.72±9.43) μm.The average and temporal RNFL thickness were significantly thinned in LHON patients compared with the control group(t=-16.357,-10.398,-17.169,-9.672,P＜0.05).There was no significant difference in average RNFL thickness between the left and right eyes (t=0.959,P＞0.05),temporal RNFL thickness between the left and right eyes was statistically significant (t=2.645,P＜0.05).Conclusion The bilateral optic radiation had significant degeneration and atrophy in chronic LHON.

Objective:To analyze the use status of antibiotics and the resistance of clinic isolate bacteria against the commonly used antibiotics before and after the intervention. Methods:Using the information retrieval systems, the consumption of antibiotics in the inpatients during the 1st quarter of 2012(before the intervention) and the same period of 2013(after the intervention) was com-pared. According to the defined daily dose ( DDDs) , the antibiotics were ranked, and the resistance rate against the commonly used antibiotics was analyzed. Results:Compared with the top ten before the intervention, the top ten after the intervention was changed sig-nificantly, however, cephalosporins was still the main species. After the intervention, the overall decline in DDDs was significant, the separation rate and distribution of bacteria remained stable. ESBLs enzyme production rate of Enterobacteriaceae Escherichia coli was re-duced by 7. 61%, and that of Klebsiella pneumoniae was reduced by 1. 34%, and the resistance rate against the commonly used antibi-otics was in an overall downward trend. The resistance rate of Gram-positive staphylococci against the commonly used antibiotics was de-creased, while that of Gram-positive enterococci showed notable difference. Conclusion:The DDDs of antibiotics and bacterial resist-ance rate are in an overall downward trend in our hospital after the intervention;however, there is still exception. Therefore, the clini-cal antimicrobial susceptibility tests should be performed as soon as possible to help the choice of antibiotics.

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 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.