Objective To know the relative efficiency condition in some cardiovascular surgical ICU for the nursing administrator to allocate the nursing resources.Methods Used the C2R model and the G2GS2 model to evaluate the effeciency of nursing manpowers in 12 cardiovascular surgical ICUs.Results The percentage of decision-making unit was 75% from the aspect of pure technique.The inefficent units can achieve the same levels of effeciency as the efficiency units by altering their inputs.Conclusions The coexistence of insufficiency and lower effeiciency were found in the nursing resource utilization of some cardiovascular surgical ICU,with a DEA based approach,we are able to provide scientific basis for the resource allocation through identifying the level of nursing efficiency.

Objective: To study the cellular immune responses and the anti-tumor effects induced by peptides derived from onco-protein HER2/neu. Methods: Two HER2/neu peptides compatible with H-2Kd binding motif as tumor rejection antigens were synthesized. The ability of inducing peptide-specific CTLs and suppressing the tumor growth in BALB/c mice immunized by HER2/neu peptide was analyzed. Results: HER2/neu peptides could promote the proliferation of BALB/c lymphocytes both in vitro and in vivo. HER2/neu peptide-specific CTLs could be induced from peptide-immu-nized BALB/c mice, which showed specifically killing effects on HER2/neu positive SP2/OHER2 cells but not on HER2/neu negative SP2/O cells. Moreover, the growth of SP2/OHER2 tumor were significantly suppressed in BALB/c mice immunized with HER2/neu peptides. Conclusion: These results suggested that it was feasible to use MHC-I epitopes derived from tumor-specific antigens as vaccines for cancer immunotherapy.

Objective:To study the inhibitory effects of an adenovirus(Ad)-based short hairpin RNA(shRNA) expression system on expression of vascular endothelial growth factor receptor(VEGFR) and on growth of colon carcinoma cells in vitro and in vivo.Methods: RNA interference pAd-Easy/VEGFR vector was used to transfect 293 cells via Lipofectamine 2000.The adenoviral vector carrying VEGFR was used to transfect CW2 cells and the transfection efficiency was determined by fluorescent microscope and flow cytometry.The expression of VEGFR was examined by RT-PCR and Western blotting.The cell growth was observed with MTT method and the growth curve was plotted.Nude mouse was transplanted with CW2 cells to establish colon cancer tumor model and the growth of tumor was observed daily.Micro-vessel density(MVD) was detected by immunohistochemistry.Results: The recombinant pAd-Easy carrying shRNA against VEGFR was verified by sequencing.Flow cytometry showed that the transfection efficiency of CW2 cells was 99.7%.RT-PCR and Western blotting showed that the expression of VEGFR in pAd-Easy/VEGFR group was obviously decreased.The growth curve showed that the cell growth in the pAd-Easy/VEGFR group was obviously slowed down.We also found that the tumor growth in the nude mouse model was obviously inhibited and the MVD was also decreased.Conclusion: pAd-Easy/VEGFR-mediated VEGFR shRNA can effectively inhibit the expression of VEGFR in CW2 cells and suppress tumor growth in vivo.

Objective To evaluate the surgical effects and methods of bipolar plasmakinetic enucleation and resection of prostate for benign prostatic hyperplasia (BPH). Methods A total of 120 patients with BPH were performed bipolar plasmakinetic resection of prostate and bipolar plasmakinetic enucleation of prostate for BPH. The blood loss,operative time,catheterization time,hospital stay and complications were monitored and analyzed. Results All of the patients were operated successfully. All the cases were followed up for 3-6 months. No urethral stricture, bladder neck contracture, rebleeding, permanent urinary incontinence occurred. The maximum flow rate increased from (6.1 ± 2.5) ml/s peroperative to (16.3 ± 2.2) ml/s at 3 months postoperative,and international prostate symptoms score (IPSS) decreased from (23.8 ± 5.2) scores peroperative to (4.6 ± 3.9) scores (P < 0.01). Conclusion Bipolar plasmakinetic enucleation and resection of prostate for BPH has many advantages such as thorough excision of the prostate,less blood loss in operation,less operation time and complications, higher security and quicker recovery, so it deserves clinical application.

Specialization development of nursing has increasing demand for nursing staff. Competency model is a professional way for the person-post matching, which may replace the job analysis as a new research direction in nursing human resource management. In this paper, the validation and application of nursing competency model were reviewed from the perspectives of competency model, to discuss the thought and method of verifying competency model, so as to lay the foundation for the clinical application of nursing competency model, and promote the rapid development of nursing.

Objective To explore the effect of team resource management mode in reducing the door-to-needle time (DNT) of acute ischemic stroke. Methods A total of 272 acute ischemic stroke patients admitted to our hospital from January to December 2014 were set as the observation group. The observation group adopted the team resource management mode which was composed of emergency triage nurses, thrombolysis group nurses, emergency CT nurses, emergency intensive care nurses, interventional radiology nurses, cerebrovascular medicine nurses and rehabilitation medicine nurses. Another 264 acute ischemic stroke patients admitted to our hospital from January to December 2013 were named as the control group who was given traditional emergency treatment mode. The DNT, the activities of daily living and the nursing service satisfaction of patients were compared between the observation group and the control group. Results The DNT, Barthel index and the nursing service satisfaction of patients in the observation group were (44.93 ±11.47) min, 65.26 ±21.36, 93.39% (240/257), which were better than those of the control group, (111.99±11.10) min, 39.53±20.56, 80.41%(197/245), the differences were significant (t=115.516, 14.559, χ2=18.740, P < 0.01). Conclusions The team resource management mode is an effective tool to shorten the DNT, promote the recovery of patients and improve the quality of patients′life.

Objective To discuss the nursing cooperation for patients with severe aortic stenosis who are receiving transcatheter aortic valve replacement using balloon-expandable aortic valve stent. Methods Percutaneous interventional transcatheter aortic valve replacement was employed in 9 patients with severe aortic stenosis. Active preoperative preparation, sufficient psychological care, close observation of vital signs and effective surgery cooperation during the operation were carried out. The clinical results were analyzed. Results Successful operation was accomplished in all the nine patients. After the surgery, all patients were in good condition, and no nursing-related complications occurred. Conclusion Correct understanding of the cooperation with the procedure of transcatheter aortic valve replacement using balloon-expandable aortic valve stent, excellent preoperative psychological care and active preoperative preparation, etc. are the most important things to ensure a successful surgery.

Objective To investigate the effect of exogenous hydrogen sulfide (H 2 S) on H2 S concentration and cystathionine β-synthase (CBS) expression in hippocampus in a rat model of vascular dementia (VaD). Methods A rat model of VaD was induced by using the modified four -vessel occlusion. The rats were divided into sham operation, model, low -dose and high-dose NaHS groups using the random number table method. They were further redivided into one day, seven -day, and 30-day subgroups according to the time after modeling. After modeling respectively, NaHS 30 μmol/kg and 100 μmol/kg were injected intraperitoneally every day in the low -dose and high-dose NaHS groups. The normal saline was injected intraperitoneally every day in the sham operation group and the VaD model group. Morris water maze test was used to evaluate the learning and memory ability of the rats. The expression of CBS in hippocampus was detected by real-time fluorescent polymerase chain reaction. Western Blotting was used to detect expression of CBS protein in hippocampus. Results Morris water maze test showed that the escape latencies of the model group, low -dose and high-dose NaHS groups were prolonged significantly compared with the sham operation group (P <0.05); the times of crossing the platform were decreased significantly compared with the model group (P <0.05); and the escape latencies were shortened significantly in the low -dose and high-dose NaHS groups compared with the model group ( P <0.05). The H2 S content in hippocampus was decreased significantly in the model group, low -dose and high-dose NaHS groups compared with the sham operation group, but the low -dose and high-dose NaHS group was significantly higher than that in the model group (all P <0.05). The expression of CBS mRNA and protein in the model, low -dose and high-dose NaHS groups was significantly lower than that of the sham operation group (all P < 0.05), and there was no significant difference between the low -dose and high-dose NaHS groups and the model group. Conclusions Exogenous H2 S may improve the learning and memory ability of the VaD rats. It may be associated with the increased H2 S content in hippocampus. However, it has no effect on CBS expression.

Objective To understand the current status and influencing factors of nursing safety management of geriatric care institutions in Shanghai. Methods Adopted questionnaire and experts spot-supervision to survey 25 geriatric nursing hospitals and 12 community health care centers which had more than 200 beds. The questionnaire had four parts including nature of institutions, general information of the managers, nursing risk management status and nursing safety quality status. Results The average score of nursing safety quality was (14.12 ± 2.03) points, there was no statistical significance in nature of institution, size of the institutions, age, education background, professional title, managerial experience, effect of nursing risk report and assessment and contingency plan (P> 0.05), but there was statistical significance in nurse managers′ knowledge about nursing risks, nursing risk management maturity and nurses training(F=2.818, 7.768, 3.555, P<0.05 or 0.01). Multiple linear regression showed that nurse managers′ knowledge about nursing risks, nursing risk management maturity and nurses training were the influence factors of nursing safety quality, and they account for 82.1%, and the regression equation was Y=7.988+0.365X1-0.380X2+0.350X3. Conclusions Strength the construction of nursing management team, perfect nursing management system, regular training could improve nursing safety quality of geriatric institutions in Shanghai.

Objective To discuss the importance of balloon occlusion test before interventional treatment of the intracranial giant intemal carotid artery aneurysms and to sum up the nursing experience in assisting the procedure. Methods Proper perioperative nursing measures were carried out for 12 patients, who suffered from intracranial giant internal carotid artery aneurysm and underwent spring coil occlusion treatment. Nursing measures included mental care, observation of the vital signs, prevention of the complications, etc. Results Neither death nor exacerbation of the condition occurred in all the 12 patients. The patients were discharged from the hospital with a mean hospitalization of nine days. During a follow-up period ranged from 4 months to one year, seven patients had no disagreeable feeling, one patient complained of discomfort but no abnormality was found on follow-up DSA, and disappearance of the aneurysm was observed in 4 patients. Conclusion The monitoring of the vital signs, the prevention of the complications and the standard nursing care are the key points for ensuring a successful operation in treating intracranial giant intemal carotid artery aneurysms with spring coil occlusion.