Objective To know the experiences of head nurses about year-ending comprehensive check of work. Methods Interviewed 10 head nurses by qualitative study methods, summarized and ana-lyzed their experiences about year-ending comprehensive check of work. Results Five subjects about the year-ending comprehensive cheek of work were summarized, they were questions about the meaning of the check, experiences of the value of the nursing management work, influence of check on emotion, expectation of the head nurses' role and the ideas about future check. Conclusions The related nursing managers should emphasis head nurses' working designation and role, and then increase their working interesting, promote clinical nursing management developing smoothly.

Objective To investigate the genotype of HPV and L1 gene polymorphism of HPV subtype 6b in patients with condyloma acuminatum (CA) from Wenzhou region. Methods Gene chips were used to profile the genotype of HPV in tissue samples from 73 patients with CA. PCR was performed to amplify the L1 gene in 11 samples positive for HPV type 6 followed by sequencing. Results Of the 73 patients, 61 (83.56%) were positive for HPV DNA. Among the 61 HPV-positive patients, 93.44% were infected with single type of HPV, and 6.56% with mixed type of HPV. In patients infected with single type of HPV, type 11 predominated with a prevalence of 29.51% followed by HPV 6 (18.03%); in those infected with mixed type of HPV, 6and 11 were the most common genotypes. Besides, sequencing analysis revealed single nucleotide polymorphism at 6 sites of HPV 6b type L1 gene, and an A/T polymorphism at position -810 was present in all samples, which was considered to be a local mutation of HPV from Wenzhou region. Conclusions In Wenzhou region, HPV types 11 and 6 prevail in patients with CA, and multiple mutations are present in L1 gene of HPV 6b type.

Objective This study was aimed to investigate the methodology of radiofrequency ablation for paroxysmal atrial fibrillation (PAF) in complicated cases Methods 130 cases (87 males) with the average age of 56 years were enrolled consecutively Each patient was diagnosed PAF by Holter and ECG After routine transseptal procedure and cannulation, retrograde pulmonary venography was taken to show the anatomic morphology of all pulmonary veins (PVs) Under the guidance of Lasso circular mapping catheter, all cases underwent electrical isolation for four PVs using the saline irrigated ablation catheter Results (1) By venography,21 PVs (16 2%) were found to have enormously dilated ostia in 21 out of 130 cases 5 PVs (3 8%) had left common trunks 3 PVs (2 3%) had right common trunks In 6 cases right PVs were found to have multiple bifurcated ostia, and the prevalence rate was 4 7% (2) A total of 341 PVs were targeted for segmental ablation in 130 cases Complete isolation was failed in 29 PVs, including 11 PVs with dilated ostia Among the 29 PVs, 14 were left superior PVs (LSPVs), 8 were left inferior PVs (LIPVs), 5 were right inferior PVs (RIPVs), and 2 were right superior PVs (RSPVs) Conclusion The anatomical variants of PV was the main cause of complicating radiofrequency ablation in patients with PAF

Objective To study programmed death-1 (PD-1) and T-cell immunoglobulin mucin3 (Tim-3) co-expression on peripheral blood mononuclear cells (PBMC) and hepatitis B virus (HBV)-specific CD8+ T cells in patients with chronic HBV infection and its correlation with liver inflammatory activities.Methods One hundred and sixty subjects with chronic HBV infection who visited the outpatient and inpatient Department of Infectious Diseases in the Third Affiliated Hospital of Sun Yatsen University were enrolled,including 63 cases of mild or moderate CHB (MCHB),31 of severe CHB (SCHB),55 of acute-on-chronic liver failure (ACLF) and 11 inactive HBsAg carriers.Twenty healthy subjects were enrolled as controls.Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect HBV DNA,enzyme-linked immunosorbent assay (ELISA) to measure HBV serological markers,and flow cytometry to detect human leukocyte antigen (HLA)-A2 and determine the expression of PD-1 and Tim-3 on PBMC and HBV-specific CD8+ T cells.Cell counts of Tim-3+,PD-1+,and Tim-3+/PD1+ PBMC and HBV-specific CD8+ T cells were compared among different groups,and their correlation with commonly used inflammatory activity indicators were studied.Analysis of variance and Kruskal-Wallis test were used for measurement data with gaussian distribution and skewed distribution,respectively.Spearman correlation analysis was used to assess the association between Tim-3/PD-1 expression and inflammatory activity indicators.Results The frequency of Tim-3+/PD-1+ PBMC was 0.25 ％ in ACLF group (P=0.0049),0.24 ％ in SCHB group (P-0.0025) and 0.13％ in MCHB group (P=0.0006),which were significantly higher than that in control group (0.03％),and the frequency of Tim-3 /PD-1-PBMC in the three groups were significantly lower than that in control group (P =0.0000),but the differences between HBsAg carriers (0.10％) and controls (0.03％) were not statistically significant (P=0.28).Among 160 subjects,78 were HLA-A2 positive.The frequency of Tim-3+/PD-1+ HBV-specific CD8+ T cells was 68.72％±17.21％ in ACLF group,and 59.66％± 19.25％ in SCHB group,which were significantly higher than that in HBsAg carrier group (33.93％ ± 10.80％,P=0.0000,P=0.0054).The frequency of Tim-3 /PD-1-HBV-specific CD8+ T cells in ACLF group was 2.80％,which was significantly lower than that in HBsAg carrier group (27.24％,P=0.0004).The frequency of Tim3+/PD-1+ HBV-specific CD8+ T cells was positively correlated with alanine aminotransferase (r=0.26,P=0.022),aspartate aminotransferase (r=0.28,P=0.012) and total bilirubin levels (r=0.36,P=0.001); and inversely correlated with albumin level (r=-0.35,P=0.002) in serum.Furthermore,it was positively correlated with international normalized ratio (INR,r=0.34,P =0.045) and model for end-stage liver disease score (r=0.43,P=0.027) in ACLF group.Conclusions Co-expressions of Tim-3 and PD-1 on PBMC and HBV-specific CD8+ T cells are significantly upregulated in patients with CHB,and correlated with liver inflammatory activities.These findings indicate that Tim-3 and PD-1 co-expression may involve in disease activity and liver failure in CHB.

Objective To evaluate the potential association of CD4+CD25+ T cells with alopecia areata.Methods Totally,this study enrolled 23 patients with progressive alopecia areata,25 patients with stable alopecia areata,and 25 healthy controls.Peripheral blood was isolated from these subjects followed by isolation of CD4+ CD25+ regulatory T cells,which were then cuhured with the presence of anti-CD3 and-CD28 monoclonal antibodies for four days.Subsequently,enzyme-linked immunosorbent assay was performed to measure the levels of interleukin (IL)-10 and transforming growth factor (TGF)-β1 in the culture supematant of these T cells.Results The levels of IL-10 and TGF-β1 were (31.68 ± 6.78) pg/ml and (32.29 ± 6.8) pg/ml respectively in the culture supernatant of CD4+CD25+ regulatory T cells from patients with progressive alopecia areata,significantly lower than those from the healthy controls ((57.34 ± 14.15) pg/ml and (57.43 ± 15.16) pg/ml,both P ＜ 0.05) and patients with stable alopecia areata ((52.56 ± 13.02) pg/ml and (61.75 ± 14.10) pg/ml,both P ＜ 0.05).However,no significant difference was observed in the supernatant levels of IL-10 or TGF-β1 between the healthy controls and patients with stable alopecia areata.Conclusions The secretion of IL-10 and TGF-β1 by CD4+CD25+ T cells is decreased in patients with progressive alopecia areata,which may contribute to the pathogenesis of alopecia areata.

Objective To explore the pathologic factors influencing the long-term survival of patients with relapsing and/or metastatic colorectal cancer (CRC) after radical operation for founding a basis for the clinical treatment protocols.MethodsThe clinical data were collected of 132 patients who were with relapsing and/or metastatic colorectal cancer (CRC) after radical resection,hospitalized from the beginning of 2002 to the end of 2007,and had integrated hospitalization and follow-up data.The relationship between the clinic pathologic factors and long-term survival was retrospectively analyzed.ResultsUnivariate analysis showed that the survival rate was higher in the patients with single recurrence and/or metastasis than in those with multiple recurrences and/or metastases,in the patients with relapsing and/or metastatic rectal cancer than in those with relapsing and/or metastatic colon cancer,and in patients received secondary operation than in those received non-operative treatment.Cox multivariable regression model analysis showed that the treatment modality for recurrence and/or metastasis,the number of recurrence and/or metastasis sites,the invasive depth of primary tumor,and lymph node metastasis were correlated with the long-term survival of patients.Among them,the treatment modality was the most important factor influencing the prognosis.ConclusionsThe recurrence and/or metastasis rate is higher in the patients with rectal cancer than in those with colon cancer,but the prognosis of the former is better than that of the latter.Secondary operation,which is helpful for the long-term survival,is suggested for the patients with relapsing and/or metastatic CRC.

Objective To evaluate the reasonability and feasibility of evaluation index system for the Capital Research Fund for Medical Development in order to provide some preliminary practical and theo-retical fundamentals for setting up and improving an evaluation index system for the Capital Research Foun-dation for Medical Development. Methods Based on the investigation of thirty three hospital's administra-tors in Beijing,we used statistical methods to evaluate the reliability and validity of the evaluation index sys-tem. Results The first grade and second grade index were approved by more than 87.88% responders;the half-reliability of the evaluation index system was 0.7933 and the Cronbach's alpha coefficient is 0.9103, the factor analysis of the second grade indicators showed that there were four factors extracted, and the accu-mulative variance reached 78.44%. Conclusion The evaluation index system for the Capital Research Fund for Medical Development is reasonable and feasible,and the research result will provide a basis for fur-ther study.

Objective To retrospectively analyze the results of treatment with Asian proximal femoral nail anti rotation intramedullary nail (PFNA Ⅱ) in senile patients with unstable intertrochanteric femoral fractures. Methods 1 06 cases of unstable intertrochanteric femoral fracture with internal fixation of PFNAⅡ were analyzed retrospectively,and the treatment effect was observed.Results 1 06 cases were followed -up(mean 1 3.5 months, ranged 1 0 -22 months).Bone union occurred in all cases,average fracture healing time was 3.8 months.The average operation time was 48 minutes,the average volume of blood loss was 1 06mL.The hip functions were analyzed using Harrison score.And found 80 excellent cases,1 4 good cases,1 2 fair cases,with 88.7% of excellent and good rate. Conclusion For the senile patients of unstable intertrochanteric femoral fractures,PFNAⅡ has the biomechanical advantages of intramedullary fixation,small trauma,short operation time,reliable internal fixation,early functional exercise,low incidence of complications,significant functional recovery,and is a preferred treatment option.

BACKGROUND: Bupivacaine is widely used to alleviate post-operation pain and cure acute and chronic pain caused by inflammation or cancer.Its analgesic time cannot meet the request that drug is released slowly to prolong the analgesic time in clinic.OBJECTIVE: To detect the alleviating effect of bupivacaine polylactic acid microspheres taking high molecular polymer-polylactic acid as vector in rabbits with high performance liquid chromatograph (HPLC) and traditional skin test method.DESIGN: A completely randomized controlled animal experimental study.SETTING: School of Pharmacy, Second Military Medical University of Chinese PLAMATERIALS: Sixteen New Zealand rabbits, weighing (2.58±0.17)kg were used in this experiment.INTERVENTIONS: The experiment was carried out at the Department of pharmaceutics, School of Pharmacy, Second Military Medical University of Chinese PLA between September and November 2002. ① Animal models were established according to traditional skin test method. ② Totally 16 New Zealand rabbits were randomly divided into 2 groups: Group A and Group B, with 8 in each one. 5 mg/kg bupivacaine parenteral solution was injected subcutaneously in Group A, 5 mg/kg bupivacaine polylactic acid microspheres were implanted between subcutaneous tissue and sarcolemma in Group B. We took 1.5 mL blood from ear border vein at 5, 10, 20, 30,45 minutes, 1, 2, 3, 4, 6, 8, 12 and 24 hours after administration of bupivacaine parenteral solution respectively in Group A and another 1.5 mL at 0.5, 1, 2, 3, 4, 5, 6, 8, 12, 24, 3 6, 48 and 60 hours after admistration of bupivacaine microsphere powder for index detection. ③ HPLC method was used to detect the concentration and releasing effect of bupivacaine in blood serum.MAIN OUTCOME MEASURES: Concentration change of bupivacaine in blood serum and efficacy diameter of local anesthetic.RESULTS:All the 16 rabbits entered the stage of result analysis. ①Change of bupivacaine concentration: Plasma bupivacaine concentration in Group A reached the peaked quickly after subutaneous injection with the high concentration of 2.466 4 mg/L, then declined quickly. Plasma bupivacaine concentration in Group B was relative stable, reached a peak much slowly after subcutaneous implantation, with peak concentration of 0.778 1 mg/L, and the plasma bupivacaine concentration maintained a relative low level, the mean retention time was obviously prolonged (P ＜ 0.05).② Alleviating effect of bupivacaine: The analgesic time was significantly longer in the bupivacaine microsphere group than in the bupivacaine parenteral solution group (P ＜ 0.05).CONCLUSION:Bupivacaine polylactic acid microspheres have sustained release effects in rabbits.

Objective To explore the association between interleukin (IL)-28B variation and spontaneous clearance of hepatitis C virus (HCV) infection.MethodsA total of 280 HCV infected patients including 200 chronic hepatitis C (CHC) patients and 80 spontaneous clearance patients of HCV infection were enrolled in the study.The rs8099917 single nucleotide polymorphyism (SNP) of IL-28B gene was detected and the association between IL-28B variation and spontaneous clearance of HCV infection was analyzed.The data were compared using chi square test.ResultsThe genotype frequencies of TT and non TT (TG and GG) of IL-28B rs8099917 between CHC patients and spontaneous clearance patients were not significantly different ( x2 =15.874,P ＜ 0.01 ). The prevalence of TT genotype in the spontaneous clearance group was 86.2％,which was higher than that in CHC group (62.0％).T and G allele frequencies in CHC group were 78.0％ and 22.0％,respectively,and those in spontaneous clearance group were 92.5％ and 7.5％,respectively,which indicated that T allele was dominant in spontaneous clearance patients. The allele frequency of rs8099917 was statistically different between the two groups (P＜0.01).The spontaneous HCV clear rate in rs8099917 TT patients was 2.84 folds of non-TT patients,while the risk of chronicity of non-TT (TG+GG) patients was 1.36 folds of TT patients.Conclusion The IL-28B (rs8099917) TT genotype is associated with spontaneous clearance of HCV infection,which can be an important factor to predict the spontaneous clearance of HCV.