Objective To identify the critical indicators of nursing practice environment in China, as a reference for related studies. Methods Descriptive systematic review was used to retrieve literature of nursing practice environment, collect all potential indicators and design questionnaires based on those indicators. In the end, 39 potential indicators were identified, for a questionnaire survey of nurses from cooperating medical institutions in 30 provinces in China, with the data subject to statistical analysis in multiple linear regression model. Results Questionnaire items of higher mean score were usually found with a smaller 95% confidence interval, while coefficient of variation tended to be lower. Seventeen indicators were recommended as key indicators for nursing practice environment in China, including proper working hours and intensity, opportunities for nurses to participate in hospital management, good working relationship with doctors within a department,nursing managers′support for nurses′right decisions. The remaining components turned out to be insignificant in the analysis. Conclusions The influencing factors for the nursing practice environment in China are different from other countries. In this consideration, nursing managers should further explore and focus on such special indicators, and proactively improve the quality of nursing practice environment for better nursing service.

Objective To explore an evaluation method of quality of care using the 2012 medical record front page.Methods The admission pathway and discharge method information of inpatients discharge recorded in the medical record front pages of the hospital were chosen and evaluated with contingency tables.Results The outcomes indicated that the differences between discharge methods of those admitted through different pathways are significant statistically (x2 =856.55,P ＜ 0.05).The correlation analysis showed that the coefficient of Spearman correlation between the inpatients admitted through different pathways and their discharge methods was -0.11 (P＜0.05).Calculated as such,the score of quality of care was 4.95 for the hospital as a whole.Conclusion The establishment of this evaluation system showed that the indicators set for quality of care using the 2012 medical record front page are scientific,and the results are more objective.

Objective To investigate the motion characteristics of primary thoracic esophageal carcinoma with four-dimensional computed tomography(4DCT).Methods Sixteen patients with primary thoracic esophageal carcinoma received respiratory gated 4DCT imaging,mapping the GTV1-GTV10 on every patient's each subsequent CT image of 10 images in the full-respiratory phase,and measuring the displacement of each centre of GTV.These displacements and directions were analyzed on different segments of esophagus.Results The mean total lung volume and GTV volume was 2993.5 cm3,35.00 cm3 and 3362.12 cm3,34.84 cm'respectively on end-expiration and end-inspiration phases(t=12.36,P=0.000and t=-0.61,P=0.546).The total mean peak to peak displacement of GTV were 0.65 mm,0.55 mm,and 2.03 nnn in x,y-and z-axis direction,respectively(F=41.14,P=0.000).The motion in x-axis,y-axis and z-axis were 0.50 mm,0.48mm,1.23 mm in the upper segment(F=5.45,P=0.017),0.68 mm,0.62 mm,1.97 mm in the middle segment(F=27.74,P=0.000),0.72 mm,0.38 mm,3.05 mm in the lower segment,respectively(F=15.61,P=0.000).Conclusions The displacement of tumor in z axis is more notable than x-,y-axis in thoracic esophageal carcinoma.The displacement of tumor x-,y-and z-axis is different in different segment of thoracic esophageal carcinoma.

Objective To study whether amputation of the tail extremity could induce change of Fos protein expression in mice ACC neurons , and explore the role of NK?1 receptor in the change. Methods Immunohistochemistry technique was adopted to study Fos protein expression change in mice ACC neurons at 0.25 h,0.5 h,1 h,2 h after amputation of the tail extremity 2.5 cm,and also the effect of NK?1 receptor antagonist GR82334(iv)or GR82334(ith)in the change. Results Fos protein expression in mice ACC neurons was significantly increased at 0.25 h,0.5 h after the amputation,and reached its peak at 1 h after the amputation,then started to decrease at 2 h after the amputation. GR82334(iv)com?pletely antagonized the significant augment in Fos protein expression in mice ACC neurons after the amputation ,but the antagonism of GR82334 (ith)was incomplete. Conclusion Amputation of the tail extremity could significantly increase the Fos protein expression of mice ACC neurons in a time?dependent manner. Both peripheral and central NK?1 receptors were involved in the process. However ,there are also central conduction pathways of other receptors and neurotransmitters involved in the significant augment in Fos protein expression in mice ACC neurons after amputa?tion.

Objective To investigate the role of vitamin D3 in anti-pancreatic cancer.Methods After treatment of different concentrations of vitamin D3 on PANC1 cells (25,50,75,100μmol/L),MTT assay was used to detect the growth inhibition rates of PANC1 cells,the early apoptotic rates of the cell were detected by flow cytometry,PTCH and Gli-1 mRNA expression were detected by RT-PCR method,and cells without treatment were used as control.Results The vitamin D3 inhibited the proliferation of PANC1 cells in a dose-dependent manner,the highest inhibition rate was at 48 hours.After 48 hours,the control group,25,50,75,100 μmol/L vitamin D3 groups' inhibition rates were 0,16.1％,18.8％,31.8％ and 39.4％,the differences among these groups were statistically significance (P ＜ 0.05).After 24 hours,the control group,25,50,75,100μmol/L vitamin D3 groups' early apoptotic rates were (5.89 ±0.57)％,(6.06 ±0.44)％,(16.21 ± 1.62)％,(16.94± 0.91)％ and (20.96 ± 0.98)％,early apoptotic rates were inhibited in a dose-dependent manner,and the differences was statistically significance (P ＜ 0.05).After 24 hours,the control group,25,50,75,100μmol/L vitamin D3 groups' PTCH mRNA expression were 0.117 ± 0.009,0.104 ± 0.011,0.069 ± 0.011,0.052 ± 0.009 and 0.056 ± 0.007,meanwhile the Gli-1 mRNA expressions were 0.323 ± 0.007,0.312 ± 0.015,0.299 ± 0.015,0.233 ± 0.007 and 0.175 ± 0.014,all in a declining trend with the increase of concentration,and the difference was statistically significant (P ＜ 0.05).After 75 μmol/L vitamin D3's intervention in 0,12,24,36 and 48 hours,the expression of PTCH mRNA were 0.142±0.008,0.127± 0.009,0.111± 0.010,0.115± 0.003 and 0.102± 0.007,meanwhile the expression of Gli-1 mRNA were 0.341 ± 0.011,0.317 ± 0.017,0.320 ± 0.018,0.226 ± 0.011 and 0.191 ±0.010,all in a declining trend with time,and the difference was statistically significance (p＜0.05).Conclusions Vitamin D3 can effectively inhibit the proliferation of PANC1 cells and promote its apoptosis,and these effects may be related to blocking of hedgehog signaling pathway.

Objective To observe long-term follow-up results of in-stent restenosis by digital subtraction angiography(DSA) method after angioplasty and stenting with the Gateway-Wingspan stenting system in middle cerebral artery(MCA).Methods Consecutive patients with ischemic stroke and Wingspan stent placement were enrolled into our study.The proportion of in-stent restenosis and ischemic stroke associated with restenosis were evaluated by DSA after 6 and 12 months of stent placement.Results 30 patients with stenosis/occlusion of MCA underwent Wingspan Stent successfully.All of the patients finished follow-up except two patients(6.7％ ) who died in the first three months after stenting.At the sixth months follow-up,in-stent restenosis was observed in 7 patients( 23.3％ ) with average (69.0 ± 9.8 )％ in-stent restenosis degree.However,no additional in-stent restenosis was found at the twelfth month,two patients among the 7 with in-tent restenosis were suffered with artery occlusion in stent.Conclusion In-stent restenosis after Wingspan stenting in middle cerebral artery was more common during the first six months,and 85.7％ with ischemic stroke.It was worthy of paying attention to prevent in-stent restenosis at the first six months after stenting.

Objective To investigate the effects of liposome mediated intraocular gene transfection of endostatin on the inhibition of the development of choroidal neovascularization (CNV) in a rat model. Methods Experimental CNV model in Brown Norway rats was induced by laser photocagulation. The recombinant eukaryotic expression plasmid pSecTagA hEndostatin or control plasmid pSecTagA and liposome complexes were injected into the subretinal space of the model rats. In situ hybridization and immunohistochemical observation confirmed the presence of endostatin mRNA and protein expression two weeks after injection. Intraocular and serum levels of endostatin were measured by enzyme linked immunosorbent assay. The intensity of fluorescein leakage from the photocoagulated lesions was studied at 13 d after photocoagulation. The area of CNV was measured using high molecular weight FITC dextran (MW2?10 6) for high resolution angiography in RPE choroid sclera flat mounts. In addition, sections of CNV lesions were studied by light microscopy and endoglin (CD105) immunohistochemical evaluation. Results The retina, RPE, choroidal were infected by subretinal delivery of the pSecTag hEndostatin and expressed the endostatin. Two weeks after intraocular injection, the level of endostatin in the whole eye homogenates were (50 14?3 43) ng/eye and (31 5?2 21) ng/eye, respectively. Fluorescein leakage from the CNV lesions decreased significantly as compared with that in the control groups. The average area of CNV at the sites of the Bruch's membrane rupture showed significant difference in eyes injected with endostatin as compared with that in the control eyes. Endothelial cells demonstrated strong immunoreactivity of CD105 in CNV lesions in the control eyes. Conclusion Liposome mediated endostatin gene transfection can significantly inhibit the development of CNV.

Objective To evaluate the safety and efficacy of adefovir dipivoxil made in China for treating hepatitis B e antigen(HBeAg)-positive chronic hepatitis B patients.Methods This was a multicenter,double-blinded,randomized controlled trial.Two hundred and thirty-eight patients with HBeAg-positive chronic hepatitis B were assigned to receive either adefovir dipivoxil(10 mg/d,120 patients)or placebo(118 patients)for 12 weeks in 5 medical centers in China.Then,both groups of patients entered 36 weeks open-labeled adefovir dipivoxil treatment phase(10 mg/d),The rates of serum HBV DNA clearances,alanine aminotransferase levels(ALT)normalization,HBeAg loss and anti-HBe seroconversion were evaluated respectively during and post the 48-week treatment.Results After 12 weeks of treatment,the rates of serum HBV DNA clearance(real-time fluorescent quanti- tative polymerase chain reaction,the detection limit was 1?10~4 copy per milliliter),ALT normaliza- tion,HBeAg loss and anti-HBe seroconversion of adefovir dipivoxil group were all significantly higher than those of placebo group(50.0% vs 5.1%,35.0% vs 8.5%,12.5% vs 2.5% and 5.8% vs 0, respectively,x~2=59.89,24.52,P0.05).The safety profile of adefovir dipivoxil was similar to that of placebo. Conclusions The safety profile and efficacy of domestic adefovir dipivoxil for treating HBeAg-positive chronic hepatitis B patients are similar to its counterparts that have been licensed aboard.

This paper presents the results of pharmacological studies on Zhi Tan Ling (ZTL). The results showed that ZTL could decrease the ischemic damage of the brain tissue in case of acute cerebral ischemia and increase synthetic metabolism, promote restoration of Cerebral thrombosis, increase cerebral blood flow, improve hemorheologic indexes and meningeal microcirculation in experimental animals. It is indicated that ZTL is effective for ischemic apoplexy through various mechanisms.

Objective To observe effect of arginine on wound healing of diabetic rats.Meth- ods Forty male Lewis rats were equally and randomly divided into diabetic group and normal control group.The diabetic group were rendered with diabetic by using intraperitoneal(IP)streptozotocin seven days prior to surgery and underwent a dorsal skin incision with implantation of polyvinyl-alcohol sponges. Either of two groups were subdivided into arginine treatment group and saline treatment group,10 rats in each group,of which the arginine treatment group received arginine at 1 g/kg per day by IP injection, while the saline treatment group received saline injection only.Animals were sacrificed 10 days post wound to observe antibreakage tension,hydroxyproline content and mRNA expression of procollagenⅠandⅢ.Results Diabetic wounds had greatly decreased breaking strengths compared with controls. Arginine significantly enhanced wound breaking strengths,increased wound hydroxyproline levels and ele- vated mRNA for procollagenⅠandⅢin both diabetic and control animals as compared to their saline-trea- ted counterparts.Conclusion Arginine can effectively promote healing of diabetic wounds in rats.