Objective To investigate the satisfaction degree with nursing for discharged patients by telephone interview,and understand the nursing quality improvement during hospitalization of patients.Methods In January and December 2011,24 clinical departments were selected as the research object,10 patients were selected from each department.The questionnaires of satisfaction degree with nursing were adopted to investigate the satisfaction degree of patients by telephone interview.The difference of satisfaction degree with nursing were compared between January and December 2011.Results Compared with the results of January,there were statistical differences in overall mean score of satisfaction degree and the dimensions of service attitude,knowledge information,ward management and working ability.While the means of dimensions of basic nursing care and care-taking patient were in high levels.Conclusions The method of telephone interview to investigate the satisfaction degree of discharged patients is direct,real and objective.It is convenient for the hospital to understand the nursing quality and existing problems during hospitalization of patients,and offers scientific way for continuous improvement of nursing service.

Objective:Adjuvant arthritis(AA)rats interfered with recombinant hIL-10,methotrexate(MTX)separately,we detected the changes of T cell subsets in rat′s blood and IL-17 A in rat′s serum.Methods:AA rats interfered with recombinant hIL-10, MTX and IL-10 plus MTX.The changes of the CD4+and CD8+T cell subsets were detected by flow cytometry;the Levels of IL-17A in serum of rats were measured by ELISA method.Results:Compare to normal control group ,the CD4+T cell total quantity and CD4+/CD8+T cell Proportion was significantly decreased , there were significant differences between the treatment group and the untreated group(P<0.05 ), the IL-17A of treatment group was significantly decreased , there was a significant differences ( P<0.05 ).The combination group had significant difference compared with IL-10 group.Conclusion:Recombinant hIL-10 can down-regulate the blood of AA rats in the number of CD4 +T cells and CD4+/CD8+ratio,reduce serum levels of IL-17A.The combination group compared with the IL-10 group effect on serum IL-17A more significantly,the results displayed recombinant hIL-10 plus MTX in the treatment of rheumatoid arthritis can better play the role.

Objective To evaluate the therapeutic efficacy of agitating thrombolysis technique for Budd-Chiari syndrome complicated with inferior vena cava (IVC) fresh thrombus. Methods From August 2004 to March 2009, 5 patients of Budd-Chiari syndrome (four males and one female, aged 36-48 years) with IVC fresh thrombus were treated with agitating thrombolysis technique. After anpography of IVC the recanalization of IVC was performed, which was followed by agitating thrombolytic therapy. Finally,IVC was dilated with percutaneous transluminal balloon angioplasty. Clinical follow-up of IVC patency was conducted by color Doppler sonography. Results After agitating thrombolysis. The thrombi were completely disappeared in all 5 patients without single occurrence of pulmonary embolism. In all patients, IVC remained patency on color Doppler ultrasonograph after following up for a mean period of 23.8 months. Conclusion Agitating thrombolysis technique is a safe and effective treatment for Budd-Chiari syndrome complicated with IVC fresh thrombus.

Objective To investigate the effect of stage 1 acute kidney injury (AKI) on the prognosis of patients underwent cardiopulmonary bypass (CPB) cardiac operation. Methods A retrospective analysis was conducted. All patients aged ≥ 18 years who underwent cardiac operation with CPB admitted to Beijing Anzhen Hospital from July 1st, 2013 to December 31st, 2015 were enrolled. According to the standard of serum creatinice (SCr) of Kidney Disease Improving Global Outcomes (KDIGO) criteria, the AKI patients with stage 1 and non-AKI patients were served as the research objects. Perioperative clinical data of two groups were collected, and the prognosis was recorded during follow up to draw the Kaplan-Meier survival curve. Cox regression model was used to analyze the risk factors of prognosis in patients with stage 1 AKI experienced CPB during cardiac operation. Results A total of 5 823 patients were enrolled, of which 1 285 patients with AKI, and those in stage 1 was 998, accounting for 77.67% of total AKI patients; and 4 538 in non-AKI group. The mean follow-up period among survivors was (23.13±12.28) months. Compared with non-AKI patients, 30-day mortality of patients with stage 1 AKI was significantly increased [4.00% (40/998) vs. 0.40% (18/4 538), P < 0.01]. It was showed by Kaplan-Meier survival analysis that the cumulative survival rate of patients with stage 1 AKI was significantly lower than that of non-AKI patients (log-rank = 51.989, P < 0.001). It was showed by further subgroup analysis that the cumulative survival rate of patients with stage 1 AKI without serum creatinine (SCr) recovery was significantly lower than that of patients with SCr recovery from stage 1 AKI (log-rank = 43.580, P = 0.000). It was showed by Cox multivariate analysis that stage 1 AKI [hazard ratio (HR) = 2.725, 95% confidence interval (95%CI) = 1.810-4.230, P = 0.000] and prolonged CPB in patients undergoing cardiac operation (HR = 1.013, 95%CI = 1.001-1.017, P = 0.000), combined with coronary heart disease (HR = 1.046, 95%CI = 1.010-1.063, P = 0.005) and diabetes mellitus (HR = 1.060, 95%CI = 1.010-1.090, P = 0.002) were independent risk factors of death in patients undergoing CPB during cardiac operation. Conclusion Stage 1 AKI is the main stage of AKI and it is independently related to all-cause mortality in patients underwent cardiovascular operation using CPB.

Objective To investigate the clinical significance of N-terminal pro-B-type natriuretic peptide(NT-proBNP) detection in evaluation of acute type A aortic dissection (AAAD) prognosis .Methods Medical records of patients with confirmed diagnosis of AAAD were retrospectively analyzed .64 patients were enrolled in accordance with the inclusion and exclusion criteria ,and were di-vided into survival group(n=56) and death group(n=8) according to prognosis .Multivariate Logistic regression analysis was em-ployed to screen the independent risk factors which would affected the prognosis .Receiver operator characteristic ,ROC) curve was used to evaluate the predictive value of NT-proBNP for AAAD prognosis .Results Differences of history of smoking ,incidence sea-son ,disturbance of consciousness ,misdiagnosis ,low density lipid-cholesterol(LDL-C) ,fasting C-peptide(FCP) ,hypersensitive C-re-active protein(hs-CRP) ,cardiac troponin I(cTnI) ,NT-proBNP ,mean arterial pressure(MAP) and prothrombin time(PT) of pa-tients between the survival group and the death group showed statistical significance (P<0 .05) .Multivariate Logistic regression a-nalysis demonstrated that smoking history ,disturbance of consciousness ,high LDL-C ,high cTnI ,high NT-proBNP and low MAP were independent risk factors for patients with poor prognosis .ROC area under the curve(AUC) of NT-proBNP prediction for peri-operative mortality risk of patients with AAAD was 0 .697(P< 0 .05 ,95% CI:0 .643~0 .733) ,and its specificity and sensitivity were 75 .85% and 70 .07% ,respectively .When NT-proBNP was 909 .69 pg/mL ,its predictive value for AAAD was the best .Set the critical value as the threshold ,the patients above were divided into the threshold above group and the threshold below group . The survival rate of patients in the threshold below group [98 .18% (54/55)] was significantly higher than that in the threshold a-bove group[22 .22% (2/9)](χ2 = 7 .211 ,P< 0 .05) .Conclusion NT-proBNP level is closely related to the prognosis of patients with AAAD and NT-proBNP detection may be conducive to predicting high risk of AAAD .

Based on their inherent relationship,some independent and verifying experiments of medical immunology were intergrated into a series of comprehensive and open experiments,which was embodied in the preparations of antiserum.so as to set up a new experiment teaching system emphasizing the training of student comprehensive capability.Achievements in training students'scientific research capacity,innovative motivation and practical working ability have been obtained and the results could provide valuable experience for innovation and reform of medical immunology experiment teaching model and method.

ObjectiveTo investigate characteristics in vitro and contrast-enhanced effect in vivo with self-made nano-scale ultrasoud-enhanced contrast agent.MethodsNano-lipid microbubbles were prepared by machine vibration and low-speed centrifugation.The surface potential and the microbubbles size were assessed by Zetasizer nano ZS90.The bubbles dispersity and micromorphous were observed under light microscopy and electron microscope.The characteristics of microbubbles were studied at various times at 4℃ environment.The enhancement duration time and intensity of nano-lipid microbubbles in nude mice livers,kidneys and subcutaneous implanted tumors were observed,and compared with micro-scale microbubbles.ResnltsThe mean diameter of nano-lipid microbubbles was (580.6 ± 36.3) nm.The contrast imaging study in vivo showed the nano-lipid microbubbles could significantly enhance ultrasonic imaging in nude mice livers,kidneys and subcutaneous implanted tumors.ConclusionsSelf-made nano-scale ultrasoudenhanced contrast agent showed good stability and contrast-enhancement effect in vitro,and provide a experimental basis for ultrasound imaging and therapeutics of malignant tumors.

Objective To explore the conditions and methods for cryopreservation and proliferation of mouse spermatogonial stem cells (SSCs). Methods SSCs were isolated from six-day-old Kunming mouse using two-step enzymatic digestion and Percoll discontinuous density gradient centrifugation. Cells were frozen with different freezing medium and cooling rate. After thaw, they were cultured in mimimum essential medium alpha (MEMα) supplemented with 10% fetal calf serum (FCS) and 100μg/L glial cell line-derived neurotrophic factor (GDNF). The survived and proliferating SSCs were examined by WST-8 colorimetric assay. Alkaline phosphatase andreverse transcription-polymerase chain reaction (RT-PCR) were performed to confirm if the cultured 96 hours germ cells were still stem cells. Results The best method to cryopreserve SSCs is using cryoprotector containing 10% dimethyl sulfoxide(DMSO), 10% FCS, 0.07mol/L sucrose and 1℃/min cooling rate, and the viability of cells in this method is more than 84%;Although the cell viability in non-programmed freezing method is less than that in the programmed freezing method, it is a simple and effective cropreservation method for mouse SSCs. What is more, the anchoring time of SSCs in this method is 8-12 hours after thaw, SSCs begin to proliferate 24 hours later, and rapid proliferation appears on the 48 hours, colonies are composed by 20-25 cells in 96 hours, when SSCs proliferated nearly 5 times.Conclusion The culture condition we used is suitable for proliferation of frozen-thawed SSCs.

Objective To compare the diagnostic value of contrast-enhanced ultrasound (CEUS) and contrast-enhanced helical CT (CECT) for various small focal nodular lesions (≤2 cm) in patients with liver cirrhosis. Methods Eighty-one small hepatic space-occupying lesions in 72 patients with liver cirrhosis were detected with CEUS and CECT, respectively. The diagnostic performance was calculated by histological results obtained from biopsy or surgery, which was considered as the gold standard, Results Fifty-three of the 81 small nodules were hepatocellular carcinoma, 26 were regenerative nodules and 2 were hemangioma. On CEUS, 51 (96.2%,51/53) HCC were hypervascular during arterial phase. On CECT, 41 (77.4%, 41/53) HCC were hypervascular (P < 0.01).Nodules which appeared by contrast enhancement during the arterial phase and contrast wash-out during the portal/late phase on CEUS or CECT were considered as HCC. The sensitivity, specificity and accuracy were 86.8% (46/53) ,82.1% (23/28) ,and 85.2 % (69/81) in CEUS, and 73.6% (39/53), 92.9 % (26/28), and 80.2 % (65/81) in CECT, respectively. Overall, there was no significant difference between CEUS and CECT in the diagnostic confidence for small hepatic nodules (P >0.05).Conclusions CEUS is superior to CECT in the detection of arterial vascularization for small hepatocellular carcinoma with a diameter ≤2 cm. The ability of CEUS in the characterization of focal nodular lesions in cirrhotic livers is similar to that of CECT.

Objective To understand the distribution and drug resistance of pathogens isolated from blood culture samples Chang’an Hospital from 2012 to 2014 to provide basis for rational use of antibacterial drugs.Methods The clinical date of distribution,changes and drug resistance of main pathogens in blood culture samples during 2012 and 2014 in chang anhospi-tal were retrospectively analyzed.Results 512 pathogenic bacterial strains were isolated from 4 792 blood culture samples in 2012~2014.Among them,gram-negative bacteria accounted for 62.50% (320/512),Escherichia coli ,Klebsiella pneumoni-ae and Pseudomonas aeruginosa accounted for 25.20% (129/512),14.26% (73/512)and 8.20% (42/512)respectively;Gram-positive bacteria accounted for 29.30% (150/512),Staphylococcus aureus and Coagulase-negative Staphylococcus ac-counted for 11.52% (59/512)and 10.16% (52/512)respectively.The rate of fungi was 7.62% (39/512).Susceptibility re-sults showed that Escherichia coli and Klebsiella pneumoniae had highly sensitive to carbapenems,but had a varying degrees of resistance to other antibacterial drugs.The rate of drug resistant of Gram-positive cocci to Penicillin,Erythromycin and Clindamycin had been a high level,but no strains being resistant to van comycin and linezolid had been detected.Conclusion The pathogens causing bloodstream infection widely distribute,and have highly drug-resistant.It is necessary to under-stand the distribution of pathogens isolated from blood culture as well as the changes of drug resistance in a timely manner so as to guide the reasonable clinical medication.