Based on JCI standard,conduct nursing practice area activities themed as the Warmness,Safe and Painless in the emergency department and outpatient department,deepen the connotation of nursing service.Use PDCA to achieve improvement simultaneously.In all these ways,we improved nursing quality,decreased sentinel event and increased satisfactory rate of the patients,enhance the nursing staff ＇s overall image,promote harmonious relations between nurses and patients.

Objective:To observe the changes of plaque microflora during the experimental gingivitis and to analyze the relationship between the plaque microflora and the clinical parameters.Methods:11 young male subjects with healthy gingiva and without systemic disease were selected.Subgingival plaque samples(2 sites /person)were collected and then smeared by Gongo red at baseline(0 day),the 7th,14th,21st day(without oral hygiene)and 28th day(7 days after reestablishing oral hygiene)respectively during experimental gingivitis.At the same time the clinical parameters were recorded.The results of smear and the clinical parameters were analyzed.Results:The percentage of spirochete was the lowest at the baseline and increased during the experimental gingivitis,and then reached the highest level on the 21st day.The percentage of spirochete of the 21st day showed the significant different compared with that of baseline(P0.05)Conclusion:Spirochete is correlated to the development of the gingivitis.

Objective: To measure GCF calprotectin and total protein for evaluating whether the calprotectin could be a sensitive marker for the initial inflammation of gingiva. Methods: Eleven young male subjects with healthy gingiva, who had no systemic diseases, were selected for this study. GCF samples (4 teeth /person) were collected with strips of filter paper at baseline (0 day), on the 7 th, 14 th, 21 st days (without oral hygiene), and 28 th day (7 days after reestablishing oral hygiene) during experimental gingivitis. The amount of calprotectin was measured by ELISA. The amount of total protein was assessed with protein dye binding assay. Results: The amount of calprotectin increased during the experimental gingivitis, and reached the highest level on the 21 st day. After oral hygiene was reestablished it reduced to the level of baseline. The amount of total protein had the same tendency as calprotectin. Conclusion: The amount of calprotectin and the total protein in GCF can reflect the initial inflammation of gingiva.

Objective To explore the associated risk factors on patients with organophosphorus poisoning combine with respiratory failure secondary pulmonary infection.Methods Two hundred and twenty-four clinical data of organophosphorus poisoning combine with respiratory failure were collected from January 2009 to May 2013.Retrospectively analyzed the situation of pulmonary infection and Logistic regression model were used to analyzed the relative risk of organophosphorus poisoning combine with respiratory failure secondary pulmonary infection.Results The secondary pulmonary infection rate of organophosphorus poisoning combine with respiratory failure was 68.75％ (154/224).Logistic regression analysis showed that combined with aspiration,hand hygiene,breathing machine,the decrease of cholinesterase activity were the relative risk factors (P ＜ 0.05).Conclusions The secondary pulmonary infection rate of organophosphorus poisoning combine with respiratory failure is higher.Combined with aspiration,hand hygiene,breathing machine,the decrease of cholinesterase activity may be the relative risk factors.

Objectives: The incidence of cervical carcinoma is increasing in young females.More and more clinical researches focus on the choice of therapeutic methods and improvement of the patients' survival.This study aimed to evaluate the efficacy of preoperative concurrent chemoradiation for stage Ⅰb-Ⅱb high-risk cervical carcinoma in young females.Methods: We retrospectively analyzed the clinical data of 118 female patients(≤35 years) with stage Ⅰb-Ⅱb high-risk cervical carcinoma,bulky,low-differentiation or non-squamous.According to preoperative treatments,the patients were divided into three groups,Group 1 preoperatively treated by concurrent chemoradiation,Group 2 by neoadjuvant chemotherapy and Group 3 by radiotherapy(intracavitary irradiation),all followed by radical hysterectomy.And those with pathologically reported pelvic lymph node metastasis,deep cervical stromal invasion,vascular tumor thrombosis,or surgical margin positivity received postoperative chemotherapy and/or radiotherapy.Results: The disappearance rate of cancer cells and the rate of superficial myometrial invasion were significantly higher in Group 1 than in the other two groups(P

Objective To study the feasibility of Brainlab plus 6-degree-of-freedom(6D) couch in the radiotherapy of head and neck by using their setup error.Methods Twenty-four patients with head and neck neoplasms in our hospital during AugustOctober 2016 were taken as the examples.After positioning by technician,each Brainlab was carried out,the setup errors in 3 translation directions of left-to-right(X),head-to-foot(Y) and abdomen to-back(Z) and 3 pivoting directions of Rx,Ry and Rz were obtained after registration of positioned CT image.After adjustment,Brainlab re-scanning was conducted for getting corrected errors.Results The online correction by Brainlab plus 6D obviously reduced the setup errors.The setup errors in all directions approached to 0,in which the difference between Ry and Rz directions had no statistical significance(P＞0.05),while the difference among the X,Y,Z and RX directions was statistically significant(P＜0.05).Conclusion The online corrections of Brainlab combined with 6D considerably reduces the errors in translation and rotation directions in radiotherapy of head and neck neoplasms,thus reduces normal tissue received amount and increases the radiotherapeutic accuracy.

Objective To compare the early outcomes of laparoscopic and open resection and evaluate the safety and feasibility of laparoscopic surgery in patients with colorectal cancer aged ≥ 70 years.Methods A total of 91 consecutive patients with colorectal adenocarcinoma underwent surgery in Yizheng City People's Hospital between Jan.2009 and Dec.2015.In 91 patients included in this study,38 received laparoscopic surgery and 53 underwent open surgery.Main outcome measures were clinical data,postoperative recovery status and short-term outcomes.Results There were no significant differences between two groups with respect to demographic indicators,clinicopathological results and chronic comorbidities had no significant difference between two groups.No death cases occured in both groups.One patient in the laparoscopic group required conversion to open surgery due to ureteral injury.Laparoscopic surgery was associated with significantly longer operating time [(238 ± 71.3) minutes vs (175 ± 60.8) minutes,P ＜ 0.001],less estimated blood loss [(145 ± 58 ml) vs (186 ± 45) ml,P ＜ 0.001)],a shorter postoperative hospital stay [(11.9 ± 3.9) days vs (14.5 ± 3.7) days],lower overall postoperative complication rate (23.7％ vs 45.3％,P =0.035),wound-related complication rate (2.6％ vs 22.6％,P =0.017) when compared with open surgery.Quality of surgical specimen,lymph nodes harvested were not significantly different between two groups.Conclusion Laparoscopic colorectal cancer surgery is safe and feasible in elderly patients,associated with better short-term outcomes when compared with open surgery.

Objective To investigate short-term effect of percutaneous discectomy combined with radiofrequency ablation with Disc-FXon contained lumbar disc herniation. Methods 36 patients were reviewed and followed up with Japanese Orthopaedic Association score(JOA score), the Visual Analogue Score (VAS) and Oswestry score for 12 months. Results The scores of JOA score, VAS and Oswestry improvedsignificantly (P<0.01) after operation. Conclusion Percutaneous discectomy combined with radiofrequency ablation with Disc-FXis effective on contained lumbar disc herniation.

OBJECTIVE: To investigate the expression and significance of muscle segment homeobox2 (Msx2) and topo II-alpha in sinonasal inverted papilloma (SNIP), and the relationship in the process of malignant transformation of SNIP. METHOD: Immunohistochemical method was used to detect the expression of Msx2 and topo II-alpha in 32 cases of SNIP, 30 cases of inflammatory nasal polyp (INP) and 30 cases of SNIP with carcinoma. According to the pathology results, SNIP were divided into mild atypical hyperplasia, moderate atypical hyperplasia and severe atypical hyperplasia. RESULT: The mean optical density of Msx2 in SNIP and SNIP with carcinoma tissues were 0.2183 +/- 0.0598 and 0.2521 +/- 0.0761,which were significantly higher than 0.1878 +/- 0. 0372 in the INP tissue (P<0.05 or 0.01). The mean optical density of topo II-alpha in SNIP and SNIP with carcinoma tissues were 0.2303 +/- 0.0397 and 0.2666 +/- 0.0483, which were significantly higher than 0.1978 +/- 0.0388 in the NIP tissue (P<0.01). There were significant difference of Msx2 and topo II-alpha in SNIP between any two of the three groups divided according to pathological morphology (P<0.01 or 0.05). The expression of Msx2 and topo II-alpha in SNIP were positively correlated (P<0.05). CONCLUSION Msx2 and topo II-alpha may play an important role in the occurrence and development of SNIP. So it can be used as new therapeutic targets.
Antigens, Neoplasm ; genetics ; metabolism ; DNA Topoisomerases, Type II ; genetics ; metabolism ; DNA-Binding Proteins ; genetics ; metabolism ; Female ; Homeodomain Proteins ; genetics ; metabolism ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; genetics ; metabolism ; pathology ; Papilloma, Inverted ; genetics ; metabolism ; pathology

Objective To investigate the significance of genomic amplification of the telomerase RNA component (TERC) gene to serve as a genetic biomarker in the screening of cervicallesions.Methods A total of 715 cases were recruited,with liquid-based cytology diagnosis as normal (n=347),atypical squamous cells of undetermined significance (ASCUS,n=180),atypical squamous cells cannot exclude a high-grade lesion (ASC-H,n=13),low-grade squamous intraepithelial lesions (LSIL,n=115),high-grade squamous intraepithelial lesions(HSIL,n=59)and atypical glandular cells(AGC,n=1).The remaining cervical cells in the cytological preserving fluid were analyzed using a two-color fluorescence in situ hybridization (FISH) probe targeted to chromosome 3q26 containing TERC gene.The TERC gene findings were compared to the cytological and histological detected results,as well as high-risk human papillomavirus (HPV) detected results.Results Genomic amplification of TERC gene was found in 5.8% of normal specimens,22.2% of ASCUS.30.8% of ASC-H,27.8% of LSIL,86.4% of HSIL and 1/1 of AGC.The positive rate was significantly lower in normal,ASCUS,ASC-H and ISIL.compared with HSIL(all P<0.01).Significantly more cells with genomic amplification of TERC gene were found in cervical intraepithelial lesion(CIN) Ⅱ-Ⅲ than CIN Ⅰ (77.8% vs.9.3%),as well as invasive cervical cancer (96.7% vs.9.3%).both P < 0.01.The rate of TERC gene amplification was higher in HPV positive patients (33.5%) than in HPV negative patients(5.2%,P<0.01).The sensitivity of TERC gene amplification was significantly higher than that of cytological screening (81.88% vs.36.96%,P<0.01) in the differentiation of CIN Ⅱ or higher and CIN Ⅰ or lower diseases,its specificity Was hisher than high-risk HPV test (93.32% vs.33.93%,P<0.01) and positive prediction value (81.29%) was similar with cytological method (86.44%,P>0.05);but its negative prediction value (93.56%) was lower than HPV test (97.06%,P<0.05).Conclusions The positive rates of TERC gene amplification increased as cervical diseases worsened.TERC gene amplification is related to HPV infection.The gain of chromosome 3q26 in cytological specimens is an effective molecular genetic biomarker in screening of CIN Ⅱ or higher and invasive cervical cancer.