Objective To establish the procedural pain nursing care protocols to improve the management of perioperative pain in elderly patients after total knee replacement,as well as to relief postoperative pain,and promote the rehabilitation.Methods 82 patients were randomly divided into the control group (45 cases) and the intervention group (37 cases).The control group was controlled by usual care,and the intervention group was offered with the standardized pain nursing care.The scores for postoperative pain,the satisfaction for analgesia,the complications associated with analgesia and the injection rate of Dolantin at 24,48,72h postoperatively were compared between two groups.Results The score for postoperative pain at rest in the intervention group was significantly lower than that in the control group at 24 h postoperatively,but there was no statistical difference at 48 h and 72 h postoperatively.Pain scores during passive activity at 24,48h,and 72h postoperatively were significantly lower in the intervention group when compared with that of the control group.The rates of side effects at 24,48,72h postoperatively in the intervention group were significantly lower than those in the control group.The injection rate of Dolantin in the control group were significantly higher than that in the intervention group.The score for both analgesia and life satisfactory in the intervention group was significantly higher than that in the intervention group at 24,48,72h postoperatively.Conclusions Procedural pain nursing care can reduce the pestoperative pain,complications and the injection rate of Dolantin in patients after total knee replacement.It can also improve elderly patients' satisfaction of analgesia and promote early recovery of their joint function.

Objective To evaluate the application effect of clinical nursing pathways in acute myocardial infarction patients by using the Meta-analysis.Methods Published randomized controlled trials (RCT) in acute myocardial infarction patients were searched and screened in CNKI,VIP,Wanfang database under present standards.The quality of the included studies was evaluated by certain standards.The Review Manager 5.0 software was taken for analysis.Results Totally 18 studies including 1877 cases were eligible to the criteria (894 in the experimental group and 983 in the control group) altogether.The Meta-analysis showed there was significant difference between the experimental group and the control group in hospitalization days,patients' satisfaction degree and rate of mastering knowledge.Significant difference existed between the experimental group and the control group in bedridden time,complication rate and the recurrence rate of myocardial infarction.Conclusions Application of clinical nursing pathway in acute myocardial infarction patients can shorten hospitalization days,increase patients' satisfaction degree and rate of mastering knowledge,decrease bedridden time,complication rate and the recurrence rate of myocardial infarction.

Ovarian cancer bears the highest mortality in gynecologic cancer, and its 5-year survival rate is about 30%. Although 70% to 80% ovarian cancer is epithelial origin, increasing evidence indicates that reciprocal interactions between tumor cells and various types of stromal cells also play important roles in driving ovarian tumor progression and that these stromal cells represent attractive therapeutic targets. This review discusses the biological signiifcance of the cross-talk between ovarian cancer cells and three major types of stromal cells (endothelial cells, ifbroblasts and macrophages) and the development of new-generation therapies that target the ovarian tumor micro-environment.

On the basis of a survey of the health manpower in the city, the authors probe into the issues of the allocation and training of the health manpower at the township and village levels. They put forward the view that it is imperative to establish and amplify the mechanism for the management of township and village health personnel and to rationally allocate and effectively utilize human resources in the health sector; to perfect the system of on the job training and assessment of health personnel and improve the quality of the working staff; and to integrate the management and training of the health manpower with other health tasks and strive for overall planning, unified operation and coordination.

Background and purpose:Ovarian cancer-associated ifbroblasts (CAF) are known to promote epithelial malignancy. The chemoattractant cytokine growth-regulated oncogene alpha (Gro-α) secreted from CAF has been reported to mediate the stroma-epithelia interaction in tumor microenvironment, leading to the development of epithelial ovarian cancer, however, the detailed mechanism is unknown.This study was to determine whether Gro-αcould promote ovarian tumorigenesis through activating NF-кB nuclear translocation and VEGF expression in stromal ifbroblasts. Methods:ELISA was used to measure the levels of Gro-αin two cancer-associated ifbroblasts (CAF) and normal ifbroblasts (NF) isolated from high-grade serous ovarian cancer or normal ovarian tissues. CAF conditioned medium (CM) or Gro-αwas used to treat NF, while PS1145, the inhibitor of NF-кB, was used as control. NF-кB subunit p65 and vascular endothelial growth factor (VEGF) were detected by Western blot in cells after treatment. Xenograft tumors from nude mice were generated by injection of CAF, NF, or OVCA429 alone or OVCA429 mixed with CAF or NF, and by injection of OVCA429 mixed with NF cells that were treated with or without CAF-CM or Gro-α, or with NF cells that were treated with CAF-CM or Gro-αplus PS1145. The tumor growth curve was measured and the blood vessel density in xenograft tumor tissues was examined by histopathological analysis. Results:The levels of Gro-αwere 5-6 folds higher in CAF than in NF. Treatment of NF with CAF-CM or Gro-αstimulated the nuclear translocation of NF-кB subunit p65, and the expression of VEGF, but suppressed the expression of thrombospondin 1, the anti-angiogenesis factor, compared with control cells. However, treatment of NF with the NF-кB inhibitor PS1145 reversed these results. The animal assay revealed that CAF stimulated tumor growth stronger than NF, and NF treated with CAF-CM or Gro-α, but not along with PS1145, enhanced xenograft tumor growth through promoting angiogenesis. Conclusion:Ovarian CAF promotes the nuclear translocation of NF-кB and the expression of VEGF through Gro-αautocrine in tumor microenvironment to facilitate angiogenesis and ovarian cancer development.

Objective To investigate the effects of S100A6 gene on invasion of human pancreatic cancer cell and possible mechanism. Methods Human pancreatic cancer BxPC3 cell line was transfected with small interfering RNA (siRNA) targeting S1006 gene, the mRNA and protein levels of S100A6 were determined by real time RT-PCR and Western blotting respectively. The invasion ability was evaluated by Transwell chamber. The matrix metalloproteinase-2 (MMP-9) activity of cancer cells was examined by gelatin zymography. Results The levels of mRNA and protein of S100A6 were greatly reduced in a dose and time dependent manner, the number of penetrating cells was greatly reduced in a dose dependent manner. The expression of S100A6 mRNA in 12.5 nmol/L of S100A6 siRNA transfected group decreased from ( 100 ±0.3)％ in control group to (15.3 ±0.2)％ ; while the expression of S100A6 protein decreased from (83.2 ±0. 18 ) ％ to ( 13.5 ± 0. 12) ％ ; the number of penetrating cells decreased from 44.5 ± 2.2 to 7.6 + 1.5 ( P ＜0. 01 ). The MMP-9 activity of siRNA group reduced significantly. Conclusions S100A6 siRNA can inhibit the invasion of pancreatic cancer cells through down-regulation of MMP-9.

Objective To investigate the potential association between 163A/G and 950T/C polymorphisms of osteoprotegerin(OPG)gene and severe pre-eclampsia.Methods Eighty-five severe preeclamptic patients and 81 normal term pregnant women(as control group)were recruited from the Department of Obstetrics and Gynecology,West China Second University Hospital,Sichuan University during the period from July 2007 to March 2009,and they were all Han population living in Chengdu,China.Genotype and allele frequencies of 163A/G and 950T/C were determined by the PCR-restriction fragment length polymorphism(RFLP)assay.Clinical and biochemical parameters for different alleles between the patients and controls were compared for statistical significance respectively,such as blood pressure,serum creatinine and 24-hour urine protein.Results The observed and expected genotype counts were consistent with Hardy-Weinberg equilibrium.No significant differences were found in the genotype and allele frequencies of 163A/G and 950T/C polymorphisms between the two groups(P ＞ 0.05).However,in the preeclamptic group,serum creatinine was significantly higher in women with the AG + GG genotypes [(76 ±24)μmol/L]compared with AA genotype[(56 ± 18)μmol/L].Reversely,birth weight was lower in the AG + GG genotypes[(2040 ± 721)g]than those in the AA genotype[(2520 ± 810)g],and the P ＜0.05,respectively.In the severe pre-eclampsia,950T/C TT genotype carriers exhibited significantly higher systolic blood pressure[(153 ± 16)mm Hg(1 mm Hg =0.133 kPa)]and 24-hour urine protein [(4.0±2.5)g]compared with TT + TC carriers[(145 ±17)mm Hg,(2.9±1.8)g],respectively,furthermore the P ＜ 0.05.Conclusions In severe pre-eclampsia,carriers with G allele at position 163A/G has more genetic predisposition than A allele carriers,as well as 950T/C T allele carriers compared with C carriers.Taken together,this study suggested that OPG gene polymorphisms might be associated with some clinical parameters of severe pre-eclampsia.

Background and purpose: Cancer-associated fibroblasts (CAFs) are known to promote the invasion and metastasis of epithelial cancers. The cytokine IL-6 may mediate the interaction between stromal cells and epithelia in tumor microenvironment to facilitate the invasiveness and metastasis of cancer, however, such mechanism has not been fully covered yet.Methods:We used cervical cancer cell line HeLa as a model for this study. ELISA was used to measure the levels of IL-6 in CAFs and normal ifbroblasts (NFs) isolated from squamous cervical cancer or normal cervical tissues. CAFs conditioned medium or IL-6 was used to treat cervical cancer HeLa cell line. The epithelial-mesenchymal transition (EMT) markers such as N-Cadherin and Vimentin were detected by Western blot in cells before and after treatment. Scratches and transwell chambers were used to test the abilities of cell migration and invasion. Results:The levels of IL-6 were 4-5 folds higher in CAFs than in NFs. Treatment of HeLa cells with CAF conditioned medium or IL-6 upregulated N-Cadherin and Vimentin, but down-regulated E-Cadherin and cytokeratin, compared with control cells, indicating that IL-6 may stimulate HeLa cells to EMT. Further study found that Snail 1, the featured transcription factor for stem cells, was increased along with the enhanced phosphorylation of STAT3. Meanwhile, the migration and invasion of HeLa cells treated with IL-6 or CAF conditioned medium were markedly increased. Conclusion:CAF induces the EMT of cervical epithelial cancer cells through IL-6/STAT3/Snail pathway, which thereby promotes the invasiveness and metastasis cervical epithelial cancer.

Objective To investigate the clonal relatedness of A.baumannii isolates from senile patients by conducting cross-sectional and longitudinal studies on antimicrobial susceptibility profiling and genomic diversity.Methods Cross-sectional study was done among the 170 non-repetitive A.baumannii isolates which were collected from senile patients during two years.Longitudinal study was conducted among 77 A.baumannii collected from 8 senile patients within longtime hospitalization.Results 75.3 ％ of the 170 isolates were non-susceptible to carbapenems,and the phenotype were XDR or MDR which spread evenly all over the senile wards.The isolates belonged to 36 pulsotypes determined by PFGE.Groups Ⅰ (contain119 isolates) were major epidemic strains,which were CRAB with XDR phenotype.In longitudinal study,comparison of pulsotypes was performed for each patient and all isolates were clustered into group Ⅰ except one isolate.All the 77 isolates were XDR.Conclusion Extensive drug-resistance of A.baumannii was a serious problem in the gerontal wards.Clone dissemina tion was the most important style of XDR strains spread.Horizontal infection control measures to interrupt person-to-person transmission should be reinforced to reduce the further spread of XDR A.baumannii.

Objective:To investigate the epidemic trend and epidemiological characteristics of human brucellosis in Chengyang District of Qingdao City, and to provide a theoretical reference for formulating scientific prevention and control measures.Methods:The data of confirmed and clinically diagnosed brucellosis cases with current address in Chengyang District of Qingdao City reported by China Disease Control and Prevention Information System from January 2016 to December 2020 were collected, and the epidemic trend, three-dimensional distribution, clinical characteristics, case consultation and disease outcome and epidemiological history of human brucellosis were descriptively analyzed.Results:From 2016 to 2020, 23 cases of human brucellosis were reported in Chengyang District of Qingdao City, with an annual incidence of 0.52/100 000, and the incidence was decreasing year by year (χ 2trend = 7.83, P = 0.005). The onset time was mainly distributed in spring and summer, of which spring (1, 5 and 5 cases respectively from March to May) accounted for 47.83% (11/23), and summer (1, 4 and 1 cases respectively from June to August) accounted for 26.09% (6/23). There were 13 cases of males and 10 cases of females, the ratio of male to female was 1.30 ∶ 1.00; the age of onset was (52.52 ± 14.67) years old, mainly from 40 to 65 years old, accounted for 65.22% (15/23); farmers accounted for 69.57% (16/23). The largest number of reported cases was in Chengyang Street (6 cases), followed by Xiazhuang Street (4 cases) and Liuting Street (4 cases), accounted for 60.87% (14/23). The main clinical manifestations were fever (21 cases, 91.30%), followed by muscle and joint soreness (18 cases, 78.26%), fatigue (18 cases, 78.26%), and hyperhidrosis (15 cases, 65.22%). The median time interval from onset to diagnosis was 27 days, and 82.61% (19/23) of the cases were diagnosed as brucellosis at the acute stage. After follow-up, 21 cases (91.30%) reached the recovery standard, and 2 cases (8.70%) improved. Verified by the epidemiological investigation, 23 cases of human brucellosis had multiple routes of infection. The main mode of infection was direct contact, including feeding suspected sick animals (8 cases, 34.78%), contacting urine, feces and other excrement of suspected sick animals (8 cases, 34.78%), delivering suspected sick animals/disposing the apoblema (5 cases, 21.74%), and slaughtering/contacting raw lamb (4 cases, 17.39%). Conclusions:From 2016 to 2020, the incidence of human brucellosis in Chengyang District of Qingdao City has decreased year by year. It occurs frequently in spring and summer, mainly in middle-aged and elderly male farmers. The main clinical manifestation is fever and there are multiple ways of infection. It is recommended to take multiple measures to strengthen health education, behavioral intervention and regular monitoring.