Objective:To screen the issues of management for radiation therapy equipment in an academic hospital with Delphi method.Methods: 6 specialists with different background were consulted with the questionnaire, and those questions were screened from questionnaire as being scored with the importance and analyzed by SPSS software.Results: 6 specialists included 2 radiation managers, 3 radiation professionals and 1 health administrative personnel. The authority coefficient was 0.88±0.06, and the activity coefficient was 100%. The Kendall concordance coefficient wereW=0.019(P=0.635) andW=0.237(P=0.001) in the 1st and 2nd round respectively. The coordination of the expert’s opinions was good and the results of the questionnaire were credible. There were 18 questions got from the questionnaire based on the averages and standard deviations.Conclusion: It was effectiveness that Delphi method can screen the issues of management for radiation equipment, on which we can get the direction of performance improvement based.

Objective To investigate antiproliferative activity of endostatin(ES), the combining effect of Endostar and radiation on VEGF and apoptosis of the A549 human lung adenoearcinoma cell line.Methods The cell of exponential phase of growth were divided into the control, radiation alone, ES alone,radiation after ES(ES→RT), ES after radiation(RT→ES), radiation and ES at equal paee (RT+ES), γ-ray radiation at a dose of 2 Gy, single fracination irradiation, YH-16 10 μg/ml in the cell culture bottle. The combining effect was quantified by the survival curve. ELISA was used to observe the VEGF of radiation with ES on A549 cell lines. Apoptosis was observed by Hoeehst staining. Results There showed that both of ES and combining treatment had the function of antiproliferative. But the union treatment's function was more obvious (P＜0.05). The expression of VEGF in ES and the combining treatment group was more lower than others (P＜0.05). On apoptosis, the rate of apoptosis in ES, RT, combining treatment group was higher than others (P＜0.05). Conclusion On antiproliferative activity and rate of apoptosis, the combining of ES and radiation is better than to use them alone. To reduce VEGF of the A549 human lung adenocareinoraa cell line by ES could enhance radioresponse. There is no evidences to show that the expression of VEGF is concerned with the different choronological order of radiation and ES.

PurposeTo explore and compare subtracted and unsubtracted volume rendering process on DSA apparatus in the diagnosis and treatment of intracranial aneurysms, and to provide a better reconstruction in clinic.Materials and Methods Twenty-seven patients with subarachnoid hemorrhage (SAH) underwent rotational cerebral angiography and 19 cases with embolization treatment underwent rotational cerebral angiography follow-up. 3D volume unsubtracted reconstruction and subtracted reconstructions were used respectively. Two sets of 3D volume reconstruction images were observed and analyzed by two neuroradiologists to compare the detection rate, image quality and post-embolization follow up.Results Thirty-three intracranial aneurysms were identiifed in 27 cases with SAH underwent three-dimensional digital angiography (3D-DA). False positives were found in 2 cases. 3D-DSA detected 33 intracranial aneurysms with no false positive case. There was no statistical signiifcance in intracranial aneurysms detection rate (χ2=1.943,P>0.05). There was no statistical significance in image quality of two reconstruction methods (Z=-1.445,P>0.05). In 19 cases with embolization treatment underwent the follow-up of rotational cerebral angiography, 3D-DA detected 3 cases with aneurysm remnants, while 3D-DSA detected 10. There was statistical signiifcance between 3D-DA and 3D-DSA when detecting aneurysm remnant (χ2=5.729,P<0.05).Conclusion Aneurysms can be well detected with better image quality by 3D-DSA and 3D-DA in the diagnosis and treatment of intracranial aneurysms. 3D-DSA can display more information on tiny vessels, and is better in detecting aneurysm remnants.

Objective:To observe the expression of B7-H4 in experimental autoimmune myocarditis (EAM).Methods:BALB/c mice were randomly divided into 2 groups:the control group and the experimental group.The mice of experimental group were injected with myosin to establish EAM models , while the mice of control group were injected with complete Freund 's adjuvant and normal saline.All the mice were killed separately at the 14th,21st,30th and 45th day for lymphocyte proliferation assay ,hematoxylin-eosin staining,immunohistochemical staining and real-time PCR.Results:The inflammation infiltration of heart was most serious at the 14th and 21st day,then it was gradually relieved with time;the results of lymphocyte proliferation assay and real-time PCR were similar to that of the inflammation infiltration of heart ,which were in high level at the 14th and 21st day,and they were both higher than that of the control group ( P<0.05 );B7-H4 protein were only detected in the experimental group ,and it was constantly expressed during the whole experiment on the endothelium of heart with myocarditis.Conclusion:B7-H4 participates in the progress of EAM ,and it may be a new way of studying the mechanism of myocarditis.

Objective To explore the relationship between posttraumatic stress disorder and nurses′ psychological capital. Methods By convenient sampling, totally 550 nurses in 5 first-class upper level general hospitals in Zhejiang province were investigated by the posttraumatic stress disorder (PTSD)Cheeklist-Civilan Version (PCL-C) and Nurses Psychological Capital Questionnaire Revision (NPCQR), and the results were analyzed. Results 18.35%investigated nurses showed a certain degree of PTSD symptoms and 13.71% showed obvious PTSD symptoms. The positive rate was 32.06%.The overall score of nurses′psychological capital was 78.81 ± 16.54, which was in the middle level, and the dimension scores from high to low were self-efficacy (23.80±5.35), hope (23.36±5.24), resilience (19.66 ±4.29), and optimism (11.99 ± 3.21). The nurses′psychological capital had a negative effect on posttraumatic stress disorder (P<0.01). Conclusions Psychological capital of nurses is a negative predictor of PTSD symptoms, which suggested that managers should pay more attention to the development of nurses′psychological capital to reduce and prevent the occurrence of posttraumatic stress disorder,then to improve nursing service quality.

Objective To establish the paclitaxel-resistant gastric cancer cell(HGC-27/PTX) and to investigate the changes of characteristics before and after resistance,as well as the possible resistant mechanisms.Methods The paclitaxel-resistant gastric cancer cell HGC-27/PTX was established by increasing paclitaxel dose gradually and intermittently.The IC50 (50% inhibitory concentration) and cell cycle were determined by CCK-8 assay and flow cytometry,respectively.The differentially expressed genes (DEGs) and signaling pathways were analyzed using RNAseq.Results The establishment of HGC-27/PTX cells lasted 9 months,and the sensitivity of paclitaxel of HGC-27/PTX cells was significantly lower than parental cells (P<0.05).Compared to parental cells,the morphology of HGC-27/PTX cells was slightly different,and the proportion of S and G2/M phase was obviously increased (P<0.01).A total of 274 DEGs were identified between the resistant and parental cells with 130 genes up-regulated and 144 genes down-regulated.DEGs were significantly enriched in extracellular matrix (ECM)-receptor interaction(P<0.001) and PI3K-Akt signaling pathways (P<0.05),which could provide evidences for reversing paclitaxel resistance.Conclusions The paclitaxel-resistant gastric cancer cells HGC-27/PTX was established with stable culturein vitro,which provides an ideal model for future study on the mechanism of drug resistance.

Objective:To analyze the intestinal preparation effect of dimethicone oil combined with polyethylene glycol electrolyte powder in painless gastrointestinal endoscopy.Methods:The study included 380 patients undergoing painless gastrointestinal endoscopy in Nanjing Qixia District Hospital from January 2020 to June 2021. They were randomly grouped into observation group and control group, with 190 patients in each group. The control group was given polyethylene glycol electrolyte powder + 0.9% sodium chloride for intestinal preparation before gastrointestinal endoscopy, and the observation group was given polyethylene glycol electrolyte powder + dimethicone silicone oil. The intestinal cleanliness, antifoam effect, colonoscopy index, detection rate of polyps, adenomas and advanced adenomas, and adverse drug reactions were compared between the two groups.Results:The satisfaction rates of intestinal cleaning and defoaming in the observation group were 92.11% (175/190) and 90.53% (172/190) respectively, which were obviously higher than those in the control group: 84.71% (161/190) and 83.16% (158/190) ( P>0.05). The entering time of colonoscopy and the time of colonoscopy inspection in the observation group were obviously shorter than those in the control group: (3.35 ± 1.05) min vs. (6.02 ± 1.68) min, (11.86 ± 1.93) min vs. (15.22 ± 2.10) min. The rinsing amount of 0.9% sodium chloride was obviously reduced: (35.68 ± 7.64) ml vs. (50.34 ± 10.30) ml ( P<0.05). The detection rate of <5 mm polyps in the observation group was obviously higher than that in the control group: 15.79% (30/190) vs. 5.79% (11/190) ( P<0.05). The detection rate of adenomas in the observation group was obviously higher than that in the control group: 24.74% (47/190) vs. 15.79% (30/190) ( P<0.05). The detection rate of advanced adenomas in the observation group was obviously higher than that in the control group: 20.53% (39/190) vs. 9.47% (18/190) ( P<0.05). The total incidences of abdominal distension and adverse reactions in the observation group were obviously lower than those in the control group: 1.05% (2/190) vs. 5.26% (10/190), 9.47% (18/190) vs. 18.42% (35/190) ( P<0.05). Conclusions:The application of polyethylene glycol electrolyte powder combined with dimethicone oil in painless gastrointestinal endoscopy can effectively improve the intestinal cleanliness, the satisfaction of removing bubbles and the detection rate of polyps and adenomas, reduce the incidence of adverse reactions, and have high clinical application value.

Objective To compare the acceptance of 2 different teaching modes－physicians and therapists teaching together and separately in continuing education students of rehabilitation medicine. Methods A questionnaire was filled by the students who attended the lectures of both Rehabilitation of Elbow Injury and Rehabilitation of Wrist Injury in the 9th National Orthopedic Class. The former lecture was taught by the rehabilitation physician and physical therapist together (together mode), and the latter lecture was taught by the rehabilitation physician and physical therapist separately (separate mode). The questionnaire included the choices and text questions. Results There were 45 copies of effective questionnaire all together. The satisfaction of both lectures were above 90%. As to teaching modes, 77.8% students liked together mode better, and 22.2% students preferd the separate mode. 93.9% students would or maybe use together mode in their future work, and 88.9% in separate mode. Conclusion The mode of physician and therapist giving lectures together is well accepted by students.

OBJECTIVETo explore the immune response of silicotic rats to sheep red blood cells(SRBC).

METHODSSilicotic rats were immunized with SRBC by tracheal instillation(Group 1) or intraperitoneal injection (Group 2), and non-silicotic rats were immunized by tracheal instillation as normal control(Group 3). The levels of serum hemolytic index(HC50) were measured on 7, 12, 20, 25, and 32 days after primary immunization and 5, 12, 15 days after the second immunization. Special anti-SRBC IgG was measured with ELISA(A490 nm) on 12, 20, 25, 32 days and 5, 12, 15, 27 days respectively. Delayed-type hypersensitivity(DTH) to SRBC was measured 20 days after second immunization and DTH reaction was determined at 24, 48, 72, and 96 h after administration. Total cell count and cell populations in the bronchoalveolar lavage fluid(BALF), lung associated lymph node(LALN) and spleen weight, special IgG secreted from spleen cells were measured at the end of the experiment.

RESULTSThe HC50 of Group 1(47.4 +/- 1.0, 52.2 +/- 4.6, 31.1 +/- 11.9, 43.8 +/- 3.5, 33.6 +/- 16.8, 49.0 +/- 2.3, 92.9 +/- 20.2, 87.7 +/- 5.2) were statistically higher than those of Group 3(40.4 +/- 10.6, 2.8 +/- 2.5, 0.8 +/- 0.6, 6.6 +/- 5.8, 1.4 +/- 0.1, 36.5 +/- 16.5, 53.0 +/- 33.2, 2.6 +/- 2.2). The special anti-SRBC IgG response in Group 1(1.67 +/- 0.19, 1.98 +/- 0.36, 1.12 +/- 0.50, 1.38 +/- 0.30, 2.75 +/- 0.15, 2.60 +/- 0.28, 2.86 +/- 0.10, 2.50 +/- 0.20) were much stronger than those in Group 3 (0.59 +/- 0.30, 0.56 +/- 0.21, 0.21 +/- 0.16, 0.22 +/- 0.01, 0.81 +/- 0.25, 0.74 +/- 0.25, 0.69 +/- 0.26, 1.38 +/- 0.41). Furthermore, the results of DTH showed positive response and the ratios for diameter of skin rash > 5 mm at 24, 48, 72, 96 h were 16/16, 16/16, 16/16, 15/16 respectively in Group 1, while those in Group 3 were 8/15, 1/15, 1/15, 1/15 respectively. Total cell count in the BALF, LALN and spleen weight, and special IgG secreted from spleen cells in Group 1 were higher too. Group 2 expressed almost of the same but with mild immunologic responses as Group 1.

CONCLUSIONSilicosis-induced extremely strong DTH and over-response of humoral immunity to some antigens may contribute to the likelihood of silicosis complicated with tuberculosis.

Animals ; Erythrocytes ; immunology ; Hypersensitivity, Delayed ; etiology ; Immunization ; Immunoglobulin G ; blood ; Rats ; Sheep ; Silicosis ; immunology

Objective: To investigate the relationship between workplace bullying and posttraumatic stress disorder (PTSD) in nursing staff, and to analyze the role of psychological capital between workplace bullying and PTSD. Methods: From December 2014 to June 2015, convenience sampling was used to collect 496 nurses from 5 grade A tertiary hospitals in a province of China. Their workplace bullying, psychological capital, and PTSD status were assessed using the Negative Acts Questionnaire, Psychological Capital Questionnaire, and Posttraumatic Stress Disorder Self-Rating Scale, respectively. The correlation between variables was analyzed using a structural equation model. Results: Among these nurses, the scores of negative acts, psychological capital, and PTSD were 37.15±12.83, 78.81±16.54, and 34.56±12.52, respectively. The score on each dimension of negative acts was positively correlated with that on each dimension of PTSD (P<0.01) ; the score on each dimension of psychological capital was negatively correlated with that on each dimension of PTSD and negative acts (P<0.01). Negative acts had a positive predictive effect on PTSD (β=0.539, P<0.01) , which was reduced after inclusion of psychological capital (β=0.513, P<0.01). The path coefficient was 0.62 for the effect of negative acts on PTSD, -0.18 for the effect of negative acts on psychological capital, and -0.11 for the effect of psychological capital on PTSD (P<0.05) . Conclusion Workplace bullying is a predictive factor for PTSD, and psychological capital plays a mediating role between workplace bullying and PTSD. The manager should reduce workplace bullying to improve the psychological capital in nursing staff and to prevent and reduce PTSD.