Objective To investigate the level and characteristics of working satisfaction of nurses, explore the role of top-up continuing education in clinical nursing work,and provide effective basis for the reasonable nursing post arrangement for nursing administrators. Methods Using cluster sampling method, the general information and the self-designed working satisfaction of clinical nurses questionnaire survey for 926 nurses from 22 three level of first-class hospitals of Guangxi Zhuang Autonomous Region. Results The total score of working satisfaction of the upgraded nurses was higher than that of the junior college nurses. The scores comparison of 6 dimensions which were nursing working identity, the work to be recognized, job autonomy, interpersonal relationship, scientific research and teaching opportunities, personal professional development were (29.25±6.27) points vs. (21.39±5.72) points, (21.96±4.73) points vs. (18.22±3.79) points, (16.67±5.21) points vs. (13.16±4.28) points, (17.83±3.56) points vs. (13.37±4.21) points, (21.32±4.63) points vs. (15.73±5.16) points, (20.51±3.52) points vs. (15.17±4.22) points, the difference was statistically significant (t=3.936, 2.762, 2.936, 3.323, 7.616, 6.215, P<0.05). There was no statistical difference between them in 2 dimensions which were scheduling situation, welfare treatment (P>0.05). Conclusions After upgraded continuing education, the comprehensive quality of nurses has been improved,and the working satisfaction has been improved significantly.

Objective To compare the clinical effect of povidone-iedine cream plus vagina scrubbing with traditional preoperative vaginal preparation method in order to seek a more safe,effective,convenient and efficient method to prepare the vagina.Methods 100 cases of married patients undergoing elective gynecological surgery were divided into the observation group and the control group with 50 patients in each.The observation group adopted povidone-iodine cream plus vagina scrubbing and the control group used traditional method.Two groups were prepared in the vagina before and after taking cervical swabs for bacterial culture to compare the positive rate of bacterial culture.Results Intra-group comparison of vaginal bacterial culture before and after vaginal preparation was significantly different,but no statistical significance was seen between the two groups.Conclusions Vagina preparation with povidoneiodine cream plus vagina scrubbing can not only reduce the workload of nurses but also improve patient comfort degree.

BACKGROUND: Vagus nerve stimulation (VNS) is a neurophysiological therapy (NPT) of refractory epilepsy, which can control the seizure by stimulating the vagus nerve stem in cervical part.OBJECTIVE: To study the effect of intermittent left-side VNS on seizure of epileptic animals, and provide theoretic basis for the interaction of somatic information and that of internal organs.DESIGN: Observation study.SETTING: Department of Neurobiology, Capital University of Medical Science.MATERIALS: The experiment was performed in the Laboratory of Electrophysiology in Department of Neurobiology, Capital University of Medical Science from March 2000 to September 2002. Thirty-four healthy adult SD rats and 8 rabbits, weighting (220-250) g and (2.2-2.5) kg respectively were selected.METHODS: ①Ten rats were intramuscularly injected with (150 000-160 000) U of penicillin (PCN). VNS effects on epileptiform activities of rats were studied by observing the changes in electrocorticogram (ECoG)and behavior of rats before and after VNS.②(0.24-0.48) mg of PCN was injected into the hippocampus of another 8 rabbits to induce epilepsy, and VNS effects on ECoG of epileptic rats were observed. ③Seizures of 16 rats were induced by Kainic acid, and changes in discharge activity of hippocampal neuron, ECoG and behavior of epileptic rats were observed after VNS. ④Seizures of 8 rabbits were induced by cortical injection of strychnine with microinjector, and VNS effects on ECoG of rabbits with epilepsy induced by acute cortical injury were observed.MAIN OUTCOME MEASURES: ①VNS effects on seizure of rats with epilepsy induced by PCN. ②VNS effects on seizure of rats with epilepsy induced by Kainic acid. ③VNS effects on epileptiform ECoG of rabbits with epilepsy induced by strychnine.RESULTS: A total of 34 rats and 8 rabbits were involved in the analysis of results. VNS could remarkably suppress the seizure of epileptic animals,and epileptiform ECoG, epileptiform discharges of hippocampal neuron and behavior significantly changed with the total effective rate greater than 50%. The total effective rate of VNS before seizure was greater than 80%.In epilepsy group indoeed by intramuscular injection of PCN, ECoG and behavior were markedlly aneliorated respectively for 40% and 50% of rats.In epilepsy group induced by injection of PCN in hippocampus, the ECoG was siguificantly ameliorated in 50% rats. In epileptic rabbit group induced by partial injection of strychnine via cerebral cortex, the epilepti form wave iu ECoG was controlled by VNS in 50 % of animals.CONCLUSION: VNS can effectively suppress seizure of epileptic animals. The antiepileptic effect of VNS is associated with cerebral cortical aud hippcampal neurons. Somatic epileptiform activity could be effectively inhibited by the integration of visceral afferent information in cortical and hippocampal parts.

Objective To analyze the outcomes and the prognostic factors of allogeneic peripheral blood stem cell transplantation (allo-PBSCT) for acute lymphoblastic leukemia (ALL).Method From Feb.2002 to Feb.2014,a total of 95 patients with ALL were treated with alloPBSCT in our hospital.Of these,73 cases obtained the first CR (CR1),11 cases obtained late CR,7 patients were in relapse and 3 patients suffered from primarily refractory disease (PRD) before transplant.The median age was 26 (4-57) years.Conditioning regimens including total body irradiation (TBI)/ etoposide/semustine/cyclophosphamide or busulfan/semustine/cyclophosphamide were used.Matched sibling transplantation was performed on 68 patients,and matched unrelated donor transplantation was performed on 27 patients.Combination of CsA,MTX and low-dose,short-course mycophenolate mofetil was used for graft-versus-host disease (GVHD) prophylaxis.The average fellow-up was 57 months.Result Hematopoietic reconstitution was achieved in all 95 patients.Five-year estimate of overall survival (OS) was 54.3％,disease free survival (DFS) was 51.2％,relapse rate (RR) was 30.2％ and transplant-related mortality (TRM) was 24.0％.The 5 year OS and DFS were significantly longer in patients with CR1 than in late CR and relapse/PRD patients before allo-PBSCT (P＜0.001).There was no significant difference in OS between the two different conditioning regimens.Multivariate analyses revealed that Ⅱ-Ⅳ aGVHD and cGVHD were correlated with higher TRM,CR1 before allo-PBSCT and TBI were associated with a lower RR,and non Ⅱ-Ⅳ aGVHD and CR1 before allo-PBSCT were favorable factors which were associated with OS and DFS.In the patients with DFS≥1 year after allo-PBSCT,DFS and OS were shorter in patients with cGVHD (P =0.008).Conclusion Allo-PBSCT in adult ALL patients should be performed in CR1.Severe acute and chronic GVHD are not associated with improved survival.

ObjectiveTo study the effect and mechanism of vagus nerve stimulation(VNS) on seizure in animal with epilepsy.MethodsSeizures of 34 rats and 8 rabbits were induced by Penicillin, Kainic acid(KA) and Strychnice respectively. Electrocorticographic(ECoG), electrical activition of hippocampal neurons and behaviour were observed to evidence the effects of left intermittent VNS .ResultsVNS could suppress seizures in animal models with epilepsy. There were significant changes in epileptiform ECoG, discharges of hippcampal neuron and behaviour. ConclusionSomatic seizure can be effectively inhibited by visceral afferent inputs through integration in cortical and hippocampal parts.

Objective To investigate the expressions of regulatory T cell (Treg) and interleukin-35 (IL-35) in patients with cholangiocarcinoma and to explore their clinical significance.Methods Flow-cytometry,PCR,Enzyme-linked immunosorbent assay (Elisa) and immunohistochemistry were used to detect the levels of Treg and IL-35 in peripheral blood and cholangiocarcinoma tissues in 42 patients with cholangiocarcinoma.Healthy volunteers were used as a control group.Result The percentage of Treg cells to CD4 + T cells in patients with cholangiocarcinoma was (5.6 ± 1.7) ％,while that in the normal control group was (2.9 ± 0.8) ％.There was a significant difference between the two groups (P ＜ 0.05).The plasma levels of IL-35 in patients with cholangiocarcinoma was (198.4 ± 81.4) pg/ml,while that in the normal control group was (33.7 ± 18.0) pg/ml.Again,a significant difference was observed between the two groups (P ＜ 0.05).In peripheral blood mononuclear cell,the IL-35 mRNA level was positively correlated with the plasma IL-35 level (p35,R =0.795,P ＜0.05;EBI3,R =0.812,P ＜ 0.05).Immunohistochemical studies showed that FOXP3 + tumor cells and Treg cells increased significantly in tumor tissues.Conclusion Overexpressions of Treg and IL-35 in peripheral blood and tumor tissues of patients with cholangiocarcinoma suggested that they may play important roles in the development of cholangiocarcinoma.

Objective To observe the effects of Salvia injection on the brain pathology,expression of synaptophysin and the synaptic ultrastructure at different time points in neonatal rats after hypoxic-ischemic brain damage (HIBD).Methods One hundred and fifteen healthy newborn SD rats of 7-day-old were randomly divided into normal group,sham group,Salvia high dose group,Salvia low dose group,and the HIBD model group.The HIBD model was prepared by ligation of the left carotid artery combined with hypoxic environment.The rats(in normal group,sham and HIBD model groups) were injected with sterile saline[9.0 mL/(kg · d)],while the rats in high and low dose groups were injected with Salvia injection [9.0 mL/(kg · d) and 4.5 mL/(kg · d) respectively].The intraperitoneal injec tion lasted for 7 and 14 days.The rats' brains were collected at one day,7 days and 14 days after the modeling respec tively.The specimens of brain tissue were observed through hematoxylin-eosin (HE),the expression of synaptophysin (SYP) was determined by using immunohistochemistry method,and the synaptic ultrastructure in the frontal cortex was observed through transmission electron microscope.Results Finally,106 newborn rats were included in statistics analysial.(1)General observation:after HIBD modeling,the neonatal rats were mostly in the left-lateral position,with difficulties in turning over,balance abnormalities,limb shaking and other abnormal behaviors,and the delay of eyes open with the left upper eyelid ptosis.(2) Pathology:the disordered and deep stained nerve cells,the degenerated and necrotic neurons were observed in the brain tissues of the HIBD model group.(3) Expression of synaptophysin:mean density of SYP in the HIBD model group was significantly lower than the normal group on day 1,day 7,and day 14 (P ＜0.05);the SYP expression in the Salvia intervention groups increased compared with the HIBD model group(P ＜ 0.05).(4) Synaptic ultrastructure:the incomplete structure of the frontal cortex neurons,the swelling organelle and the synaptic structure damage were observed in the HIBD rats.Compared with the HIBD model group,the neuronic and synaptic ultrastructure were improved by the intervention treatment of high and low dose Salvia injection.Conclusions The mechanism of Salvia injection in treatment of neonatal rats with HIBD may be associated with the improvement in neuronal ultrastructure and synaptic reorganization.

Objective:To explore the development characteristics of empathy in adolescents and the relations with aggression.Methods:With multistage stratified random sampling method,15 738 middle school students were selected from 5 provinces across China.The Buss-Warren Aggression Questionnaire Revised in China (BWAQ-RC) and Interactional Reactivity Index (IRI-C)was used to measure adolescents'aggression and empathy.Results:Girls had higher level of empathy than boys (P <0.001).Age and gender were interacted in predicting empathetic con-cern (P <0.001).Perspective taking was significant negative predictor of indirect aggression,physical aggression, hostile and angry (P <0.001),while empathetic concern was significant positive predictor of indirect aggression, verbal aggression,hostile and angry (P <0.001).Empathy was divided into 4 class used the K-Means clustering a-nalysis,namely,low empathy class,high perspective taking class,high empathetic concern class,high perspective taking and empathetic concern class.In contrast to other classes,individuals in low empathy class were more likely to involve in physical aggression (P <0.05),and individuals in high level of perspective taking and empathetic con-cern class were related with less physical aggression and elevated verbal aggression (P <0.05).Individuals in high empathetic concern class exhibited more indirect aggression,hostile and anger than other subgroups (P <0.05). Conclusion:The unbalance development of the two components of empathy may be closely correlated with different conduction of aggressive behaviors.

Objective To study and correlate serum bilirubin and regulatory T cell (Treg) levels in patients with bile duct stone.Methods Flow-cytometry and Enzyme-linked immunosorbent assay (Elisa) were used to study the peripheral blood expression level of Tregs and the bilirubin level in 27 patients with bile duct stones and jaundice.The changes in the expression level of Tregs and the bilirubin level were studied and correlated before and after treatment.Results After treatment,both the peripheral blood bilirubin level,the Tregs expression level and the cell cytokines decreased significantly.The total bilirubin level decreased from (102.8 ± 33.1) mmol/L to (15.3 ± 5.7) mmol/L (P ＜ 0.05),the direct bilirubin level decreased from (38.1 ± 12.8) mmol/L to (5.0 ± 1.6) mmol/L (P ＜0.05);the percentages of CD4+ CD25 +Foxp3 + T cells in CD4+ T decreased from (4.2 ± 2.0) ％ to (2.4 ± 1.0) ％ (P ＜ 0.05).Before treatment,the levels of IL-10 and TGF-β were 171.4 ± 13.7 and 2016 ±657 pg/ml but after treatment,the two cytokines decreased to 92.1 ± 7.4 and 1 686 ± 168 pg/ml,respectively (P ＜ 0.05).Conclusions Patients with bile duct stones and jaundice presented with high expressions of bilirubin and Tregs level.These expressions returned to normal after effective treatment.The Tregs expression level was positively correlated with the bilirubin level.

Objective To investigate the use of laryngeal mask airway (LMA) ProSeal for airway management during open heart surgery performed under CPB in children. Methods Seventy-six ASA Ⅱ and NYHA class Ⅰ or Ⅱ patients aged 3 months-8 yr, weighing 3.3-34.5 kg undergoing open heart surgery under CPB were randomly divided into 2 groups ( n = 38 each): tracheal intubation group (group T) and ProSeal LMA group (group P1). Tracheal tube and LMA were inserted after induction of anesthesia with 8% sevoflurane. The rate of successfultracheal intubation and LMA placement, placement time, peak airway pressure and side effects during and after surgery including hypoxemia, tachycardia, bradycardia, hypotension and hypertension, laryngesl edema, dysphagia, bucking, dyspnea and hoarseness were recorded. Results There were no significant differences in the rate of successftl tracheal intubation and LMA placement, peak airway pressure, bucking, dyspnea and hoarse voice between the two groups (P＞ 0.05). The LMA placement time was significantly shorter than tracheal intubation time and the incidence of laryngeal edema and dysphagia lower in group P than in group T ( P ＜ 0.05). Conclusion The LMA ProSeal can provide adequate ventilation during operation with less complications and can be used effectively for cardiac surgery performed under CPB in children.