In the implementation of community health service,the working efficiency of the community nurses becomes increasingly important to the overall service standards of the service centers as the local residents have begun to take it into consideration when evaluating the service quality.By illustrating the roles of nurses in all the six major functions played by the community health service,this paper intends to arouse the attention from the concerning authorities to the training of the nurses so that the nurses can be developed in an all-round way and provide better services for the community.

Objective To explore the pathogenesis of invasive pituitary adenomas,and to improve the effect of clinical treatment.Methods 15 pairs of invasive pituitary adenoma tissues and noninvasive pituitary adenoma tissues were selected from 114 specimens collected and the Id1 gene expression and Id1 protein expression in invasive pituitary adenoma tissues and noninvasive pituitary adenoma tissues were tested by quantitative RT-PCR,Western blot and immunohistochemical methods;Then small interfering RNA (siRNA) was used to interfer Id1 gene expression in NQ-04 cells.Results The Id1 gene expression in invasive pituitary adenoma tissues was significantly higher than that in noninvasive pituitary adenoma tissues(n =15,t =2.725,P =0.013) ;The migration of pituitary adenoma cells interfered was significantly reduced.Conclusion The invasive pituitary adenoma tissues has high level of Id1 gene expression,which may be correlated with its invasion.And Id1 is expected to become a biological marker of diagnosis and determination in the prognosis of pituitary adenoma.

Objective To determine the effect of resurfacing completely degloved thumbs by free perforator flaps in a spiral fashion.Methods A retrospective case series study was made on 22 patients with completely degloving injury of the thumb treated by different free perforator flaps in a spiral fashion from June 2009 to December 2014,including 19 male and 3 female patients at the age of 18-46 years (mean,27.8 years).A total of 13 patients were reconstructed using the medial arm perforator flaps ranging in size from 8.0 cm × 3.0 cm-14.5 cm × 3.5 cm,and 9 patients were reconstructed using the peroneal artery perforator flaps ranging in size from 6.0 cm × 3.5 cm-21.0 cm × 10.0 cm.Follow-up was made to evaluate the sensation,appearance and function of the thumbs and the recovery of flap donor sites.Results All flaps survived completely,with no occurrence of postoperative vascular crisis and infection.Only one medial arm flap and one soleus perforator flap distal flap showed blood flow disorder in the distal sections and were healed uneventfully after conservative therapy.Function and cosmetic recovery of the reconstructed thumbs were good.Follow-up ranged from 9 to 22 months (mean,14.5 months).Twopoint discrimination test of the flaps was recovered to 6-13 mm.No linear scar contracture was left.Flap donor site wound healed primarily.All patients were satisfied with the overall results.Conclusion The free perforator flap in a spiral fashion can avoid linear scar contracture,maximally decrease donor site morbidity and achieve satisfactory functional recovery and good aesthetic restoration,indicating a good candidate for reconstruction of thumb degloving injury.

OBJECTIVE:To establish a RP-HPLC method for simultaneous determination of caffine,acetaminophen and isopropylphenazone in human plasma after oral dose of saridon.METHODS:Hypersil Hypurity TM Advance was used as chromatographic column and the mobile phase was a mixture of0.01mol/L phosphoric acid-methanol-tetrahydrofuran(86∶12∶2).The detection wavelength was273nm.RESULTS:The calibration curves were linear in the ranges of0.39～100.0?g/ml for caffine,1.96～500.0?g/ml for acetaminophen,and1.17～300.0?g/ml for isopropylphenazone,respectively.The accuracy of all was higher than95.0%.The inter-day and intra-day RSD was less than10.0%.CONCLUSION:The present method is sensitive,accurate,convenient,and highly specific,which can meet the requirement in plasma determination of three components in Saridon tablet.

Objective To provide evidence for clinical practice by analyzing the factors associated with bloodstream infection in ICU patients through retrospective case-control study. Methods Using self-made data collection form, 133 cases of blood sample record from HIS system during May 2013 to December 2015 at Peking Union Medical College Hospital ICU ward were collected. In this study, 54 patients with positive blood culture results were allocated to the case group while 79 patients with negative results were in the control group. Baseline characteristics, which included sex, age and chronic diseases, were almost the same between both groups. Binary Logistic regression analysis was used to identify factors related to blood infection. Results During May 2013 to December 2015, there were 54 blood infectious cases, among which 19 cases with positive gram bacteria accounted for 35.2%(19/54), 57.4%(31/54) of gram-negative bacilli and 7.4%(4/54) of fungal infection. Logistic regression analysis revealed that blood filtration treatment (OR=7.691), pulmonary infection (OR=7.682), ICU (OR=1.115), Acute Physiology and Chronic Health Evaluation (APACHEⅡ) scores(OR=1.096), procalcitonin (OR=1.065) were risk factors of bloodstream infection for ICU patients, while albumin (OR=0.763) was a protective factor. Conclusions Blood filtration treatment, pulmonary infection, hospital length of stay, APACHEⅡand procalcitonin are factors associated with bloodstream infection in ICU patients. Clinical procedures in ICU should mainly focus on improvement of prevention awareness, strict aseptic technology, professional quality of nursing staff. Besides, guarantee of patients′nutrition, effective treatment of primary diseases, and shortened hospital length of stay are also important to reduce the infection and improve quality of life of these patients.

Objective Medication for pituitary adenomas is mainly targeted on the prolactin-secreting and growth-hormone types and shows poor therapeutic effects on other adenomas .Therefore, new drugs urgently need to be developed for this purpose .This study was to investigate the effects of glivec and everolimus on mouse pituitary AtT-20 cells and their molecular mechanisms in vitro. Methods Mouse pituitary AtT-20 cells were incubated with glivec or everolimus or combination of both and their inhibitory effect on the proliferation of the cells was measured by CCK-8 assay.The mRNA levels of AKT and ERK were determined by q-PCR and the ex-pressions of the phosphorylated AKT (p-AKT) and ERK (p-ERK) were detected by Western blot. Results Used alone, both glivec and everolimus inhibited the proliferation of the AtT-20 cells in a time-and dose-dependent manner , but their combination produced a mutually antagonistic effect, with combination index values of 1.13 ±0.06, 1.12 ±0.03, and 1.07 ±0.03 respectively.The two a-gents , either used alone or in combination , induced no significantly inhibitory effects on the mRNA and protein expressions of AKT and ERK ( P >0.05 ).Both glivec and everolimus up-regulated the expressions of p-AKT and p-ERK, and their combination manifested an even stronger effect (P>0.05). Conclusion Both glivec and everolimus inhibit the proliferation of AtT-20 cells when administered alone, but their combination produces an antagonistic effect .Their action mechanism might be that when targeting some signaling path-ways to inhibit cell proliferation , glivec, as well as everolimus , in-duces a feedback activation of AKT and ERK .

Dermatitis, Occupational ; diagnosis ; Diagnostic Errors ; Female ; Humans ; Trichloroethylene ; adverse effects ; Young Adult

0.05). Conclusion Ryanodine receptor of asthmatic guinea-pig showed hypersensitivity. Under specified condition, the characteristics of ryanodine receptor still retains in subcultured ASMCs of asthmatic guinea-pig.

Objective To study the effect of candesartan on the ERK1/2 protein expression in myocardium of epilepsy rats induced by kainic acid(KA) and its mechanism.Methods 105 male Wistar rats were divided into: control group(A);epilepsy groups(B1-5);candesartan groups(C1-5);1-5 meaned 0,0.5,2,4,6 h after epilepsy,respectively.Epilepsy rat models were made by injecting KA into amygdale under stereotactic instrument.The ERK1/2 protein expression in various groups were tested with immunohistological method.Results Compared with control group,the protein expressions of ERK1/2 increased significantly in the 0.5 h groups of B and C(P0.05).The differences in the level of ERK1/2 protein expression between B and C groups were significant(P

BACKGROUND: Matrix attachment region (MAR), a DNA sequence, is still bound to the nuclear matrices after chromatindigested with restriction endonuclease, not only affects expression of endogenous gene, but also overcames transgenic silence andimproves transcription and expression of exogenous gene. OBJECTIVE: To investigate the influence of ?-interferon MAR of CHO cells on the transgenic expression of chloramphenicolacetyltransferase (CAT). DESIGN, TIME AND SETTING: The opening experiment was performed at the Department of Biochemistry and MolecularBiology, Molecular Institute, Xinxiang Medical College from October 2006 to April 2007. MATERIALS: CHO cell lines were obtained from China Center for Type Culture Collection. The pCATG vector of CAT and G418screening markers were constructed by this laboratory. METHODS: Human ?-interferon MAR by PCR was digested with SacI/KpnI and BamHI/SalI, and was inserted into pCATGvector, which was propagated in Escherichia coli JM109, then extracted and purified followed by enzyme digestion analysis. Vectorof CAT expression cassette and human ?-interferon MAR by the two sides was successfully constructed, and christened aspCAT-MAR. Two methods were compared between CHO cells of pCATG transformation and CHO cells of pCATG-MARtransformation. After G418 selecting, genome DNA of cell lines of G418 was extracted, then primers for PCR to amplify the CATtarget gene fragment was designed. MAIN OUTCOME MEASURES: The activity of CAT was analyzed by ELISA method. It was also tested to see if thepCATG-MAR was stably integrated into genomic DNA in the transfected cells. RESULTS: CHO cells of pCATG transformation was screened to have 16 strains of positive cell, and CHO cells of pCATG-MARtransformation was screened to have 17 strains of positive cell. Human ?-interferon MAR could increase the CAT gene expressionby 2.8 fold. The coefficient of variation of CHO cells of pCATG transformation was 2.065 0, and coefficient of variation of CHOcells of pCATG-MAR transformation was 0.813 1. Genome DNA of stable transformation cell lines was amplified by a fragment of437 bp. The results confirmed the pCAT-MAR vector was stably integrated into genomic DNA. CONCLUSION: Human ?-interferon MAR can increase transgenic expression in CHO cells and decrease the transgenicexpression variation in different transfected cells.