Objective To explore the clinical characteristics and treatment strategies in preterm premature rupture of membranes.Methods The clinical data of 730 cases with preterm premature rupture of membranes from January 2005 to December 2009 in our hospital were retrospectively analyzed.The characteristics and perinatal outcomes were summarized.Results The incidence rate of preterm premature rupture of membranes was 2.68 %.The relative factors developing preterm premature rupture of membranes were in turn infection,high tension of uterus and abnormal fetal position.The perinatal complications were mainly preterm,fetal distress and RDS.The perinatal outcomes were directly related to the gestational weeks.Conclusion According to the relative factors leading to preterm premature rupture of membranes,adopting the relative clinical treatment,strengthening the gestational health and comprehensive treatment may reduce the morbidity of maternal and newborn and improve the prognosis of preterm neonates.

Objective: To study the effects of light intensity on the compressive strength and tensile strength of light -curing composite resin. Methods: 25 samples of Shade A (Dentsply,USA) light-curing composite resion in the size of 10?5?1(mm) and equally divided into 5 groups.The light intensities (mW/cm 2?40 s) of 300,500,800,300 mW/cm 2?10 s+500 mW/cm 2?30 s,300 mW/cm 2?10 s+800 mW/cm?30 s were applied during the light-curing in group 1,2,3,4 and 5 respectively.The compressive strength and tensile strength of of the samples were measured by computer-controlled electronic testing machine (type WDW-100). Results:The compressive strengths (MPa) of group 1,2,3,4 and 5 were 228.68?20.25,274.67?6.99,380.53?9.81,345.47?10.71 and 414.06?29.34 respectively (P

Objective This paper reports a modified method for the isolation of rat thoracic aortic vascular smooth muscle cells based on combined enzyme double digestion.Methods An enzyme mixture containing collagenase II, soybean trypsin inhibitor and elastase was prepared and used to remove the aortic tunica intima and tunica adventitia, and then the tunica media was subjected to second digestion using the same enzyme mixture and to isolate vascular smooth muscle cells.Results The isolated VSMCs were cultured in vitro and the growing cells had an elongated spindle-shape, reached confluence within a week, and displaying a typical hill-and-valley pattern.After 1 week, the cells were passaged.Contractile smooth muscle markers(α-SMA, myosin-II and β-tubulin) were highly expressed in the isolated cells.More than 90% of the cells significantly expressed alpha smooth muscle actin and myosin-II.Conclusions Themethod established in this study has advantages of simple and easy to operate, and good reproducibility, with a high activity and purity of the separated cells.It can ensure to obtain a large amount of contraction-type vascular smooth muscle cells within a short time.

Objective To investigate the quality of life (QOL) and its influential factors in the aged patients with ulcerative colitis (UC).Methods A cross-sectional survey of the UC patients was conducted by Chinese version of inflammatory bowel disease questionnaire (C-IBDQ).The influential factors for QOL in elderly patients with UC were evaluated and analyzed by correlation analysis and multiple linear regression analysis.Results A total of 90 aged UC patients finished the questionnaire study.The overall score of QOL in the aged UC patients was (175.7±37.6),and the score of each item was decreased,especially in the aspect of economic burden,emotional function and systemic symptoms.Multiple linear regression analysis indicated that the influential factors for QOL were sex,disease severity,duration,disease activity and the payment.The scores of bowel symptoms were higher in men than in women [(53.9±12.1) vs.(49.1±10.5),P=0.049].The QOL scores were lower in patients with the duration less than one year than over one year (P＜ 0.05).The QOL scores were lower in severe patients than in mild patients (P＜ 0.05).The QOL scores were lower in patients during active period than during remission period [(149.7 ± 35.1) vs.(193.9 ± 27.3),t=6.731,P=0.000].The QOL scores of patients whose medical cost was mainly paid by themselves were lower than those paid by insurance.And there were significant differences in systemic symptom,social function and economic burden (all P＜ 0.05).Conclusions The QOL of the aged UC patients is impaired in varying degree.The influential factors for QOL are sex,disease severity,duration,disease activity and the payment.The QOL in UC patients is obviously affected by economic burden.

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 study the mechanism of chemotherapy resistance caused by interleukin-6 (IL-6) in ovarian cancer cells and its related signal pathways. Methods Ovarian cancer cell lines A2780(IL-6 receptor positive, while non-IL-6-expressing and cisplatin/paclitaxel-responsive) and SKOV3 cell lines( overexpressing of IL-6 receptor and IL-6 and cisplatin/paclitaxel-resistant) were suitable models for this study. The effect of exogenous (a short period of treatment with recombination IL-6) and endogenous IL-6(by transfecting with plasmid encoding for sense IL-6 ) in A2780 cells or deleting of endogenous IL-6expression in SKOV3 cells (by transfecting with plasmid encoding for antisense IL-6) on the sensitivity to cisplatin and paclitaxel was investigated. Meanwhile, the mechanism of chemotherapy resistance caused by IL-6 in ovarian cancer cells and its related signal pathways were also analyzed. Results We found that both exogenous and endogenous IL-6 induce cisplatin and paclitaxel resistance in non-IL-6-expressing A2780 cells (the resistance multiple to cisplatin and paclitaxel was: exogenous, 6. 25 and 7.31; endogenous, 7. 13 -8. 34 and 7. 61 - 10. 70), while deleting of endogenous IL-6 expression in IL-6-overexpressing SKOV3 cells promotes its sensitivity to anticancer drugs ( the resistance multiple to cisplatin and paclitaxel was 0. 15 and 0. 10, 0. 10 and 0. 08). IL-6 significantly up-regulated the expression levels of mRNA and protein of drug resistance-associated genes, MDR1 and GST-π, and apoptosis-inhibiting genes, bcl-2, bcl-xL and XIAP in a dose-dependent manner in A2780 cells. In accordance with this finding, the mRNA and protein levels of MDR1 and GST-π enhanced in sense IL-6-transfected A2780 cells, and reduced in antisense IL-6-transfected SKOV3 cells compared with the corresponding parental and control vector-transfected cells, which had no difference. It was found that PD98059 [ mitogen-activated protein kinase-extracellular signalregulated kinase (MEK) inhibitor ] and wortmannin [ phosphatidylinositol 3-kinase (PI3K) inhibitor ]significantly antagonized IL-6-induced phosphorylation of extracellular signal-regulated kinase ( ERK ) and protein kinase B (Akt), respectively, and both of them blocked IL-6-induced cisplatin and paclitaxel resistance and the inhibitory effects of PD98059 and wortmannin were dependent on its concentration.Conclusions These data suggest that IL-6-induced chemoresistance may be associated with increase of both drug resistance-associated genes ( MDR1 and GST-π) and apoptosis-inhibiting genes ( bcl-2, bcl-xL and XIAP), and activation of MEK/ERK and PL3K/Akt. Therefore, modulation of IL-6 expression or its related signaling pathway may be a promising strategy of treatment for drug-resistant ovarian cancer.

Objective The aim of this study was to compare the basic characters of the speech - evoked audi‐tory brainstem response (speech - ABR) in healthy young women with that in post - menopause women and to get the changes of the probable factors for the auditory brainstem pathway encoding of speech sounds in healthy post -menopause women .Methods Speech - ABR of forty - seven normal hearing subjects including twenty - seven young women and twenty post - menopause women were recorded .The speech syllable /da/ as stimulus sound was trans‐mited to right ear by the insert earphones in speech - ABR test .Results The response waves of speech - ABR in post - menopause women were similar to those in young women ,which containal the onset responses (peak V and A) ,the transition (peak C) ,the frequency following responses (peak D ,E and F) and the offset response (peak O) .Except wave C ,the latency of wave V (6 .99 ± 0 .34ms) ,wave A (8 .32 ± 0 .49 ms) and wave O (48 .86 ± 0 .50 ms) in post - menopause women were evidently longer than those of in young women (the waveV :6 .60 ± 0 .25 ms ,wave A :7 .56 ± 0 .31 ms and wave O :47 .88 ± 0 .31 ms) ,while the amplitude of wave A ( - 0 .16 ± 0 .06 μV ) and O ( - 0 .12 ± 0 .06 μV ) in post - menopause women were obviously lower (modulus) than those of in young women (the wave A : - 0 .27 ± 0 .08 μV and O : - 0 .18 ± 0 .07 μV)(P< 0 .05) .In the FFR of speech - ABR ,the latency of wave D (23 .27 ± 0 .67 ms) ,wave E (31 .88 ± 0 .58 ms) and F (40 .61 ± 1 .22 ms) in post - menopause women were also longer than those of in young women (the wave D :22 .40 ± 0 .44 ms ,wave E :31 .00 ± 0 .43 ms and F :39 .53 ± 0 .61 ms) .Besides ,the amplitudes of wave D ( - 0 .12 ± 0 .04 μV ) and F ( - 0 .08 ± 0 .06 μV ) in post -menopause women were visibly lower (modulus) than those of in young women (the wave D : - 0 .17 ± 0 .08 μV and F : - 0 .16 ± 0 .07 μV)(P< 0 .05) . ④ The V /A slope also showed very significant difference ,the V/A slope in young women was much bigger than that in post - menopause women (P< 0 .05) .Conclusion The synchronism and phase locking of auditory brainstem pathway to processing and encoding capability in healthy post - menopause women is poorer than those of in young women .It may suggest that the growth of the age and the decrease of hor‐mone will weaken the ability to processing of speech sounds in women .

Objective To explore the value of dual energy CT displaying knee joint torn posterior cruciate ligament (PCL). Methods Ten cases with single knee joint torn PCL were scanned by 1.5 TMR and dual energy CT. By the use of postprocessing technique of muhiplanar reformation (MPR) and volume rendering technique (VRT), the CT value,length,thickness of PCL were assessed by paired t test respectively. Results MPR and VRT clearly displayed the PCL. The CT value of the patient sides and normal sides were(60.10±3.21), (72.98±7.35) HU(t=4.33,P=0.006), the length were(4.42±0.56),(4.14±0.49) cm (t=-1.20,P=0.285), the thickness of the attachment site and middle sire were (0.88±0.19), (0.58±0.10), (0.38±0.12) cm and (0.43±0.07), (0.39±0.03), (0.43±0.12) cm (t=-6.89,P=0.001;t=-4.38,P=0.007;t=0.85,P=0.587) respectively. Conclusion Dual energy CT can demonstrate clearly the ligament with three-dimension display,and may provide important information for diagnosis and per-surgical evaluation.