Objective To study the average difference of CHN atlas method bone age (BA) determination (left-vs.right-hand) for children and adolescents.Methods Radiographs of hands of healthy children and adolescent (age range:1.0-19.0 years) were analysed to determine BA,producing analysis results for 1380 hand images.The images were assessed by two radiologists based on CHN atlas method,who were blinded to the chronological age (CA) of them.The intra-and inter-observer variations were used for evaluating the reliability of CHN atlas method.The difference of BA using left-or right-hand BA was evaluated by t test.Results No significant difference was found for intra-or inter-observer variations (P ＞ 0.05).The BAs of left-and right-hand radiograph showed significant difference in the groups for boys (16.0-16.9,17.0-17.9 years),girls (6.0-6.9 years) and both of them (6.0-6.9,16.0-16.9 years).The regression model analysis showed no significant difference(t =-0.427,P =0.670).Conclusion Comparison of left-and right-hand BA shos no significant difference using CHN atlas method,indicating that either hand could be used to determine BA.

Objective To analyze risk cause on adverse apparatus events of medical institution for causing the attention of medical institutions and reducing or exempting the occurrences. Methods Through the analysis risk cause on adverse apparatus events of medical institutions, the major factors of causing the medical institutions adverse apparatus events and the ways of solving the problems were found. Results The ways and countermeasure of solving medical institutions adverse apparatus events are brought forward. Conclusion It is preventable in adverse apparatus events of medical institutions.

Objective:To establish the quality standard for Huashengping capsules. Methods: Milkvetch Root, Hedyotis diffusa Willd and Salvia miltiorrhiza were identified by TLC. The content of astragaloside A was detected by HPLC. The column was Kormasil C18(250 mm ×4.6 mm, 5 μm) and the flow rate was 1.0 ml·min-1. The mobile phases was a mixture of acetonitrile-water (32∶68 ) . The detection wavelength was 203 nm. The column temperature was 25℃ and the sample size was 20μl. Results:The TLC chro-matography spots were clear. Astragaloside A was linear within the range of 2. 000-10. 000 μg(r=0. 999 6) and the average recovery was 100. 8%(RSD=1. 9%,n=6). Conclusion:The method is simple, accurate and reliable, which can be used in the quality con-trol of Huashengping capsules.

Objective To analyze the correlation between LC-MS/MS method and enzymatic cycling assay for determination of homocysteine concentration in human serum,and the application of two methods in the determination of homocysteine concentration.Methods Homocysteine concentrations of 63 serum samples were collected and determined by LC-MS/MS method and enzymatic cycling assay,respectively.The correlation between the concentrations by different methods was analyzed and evaluated.Results The concentrations were(19.11 ± 15.69) μmol/L by LC-MS/MS method and(16.95 ± 14.41) μmol/L by enzymatic cycling assay,the P value evaluated by paired-samples T test showed that there was statistical difference among the concentrations determined by two different methods (t =6.25,P ＜ 0.05).The conversion formula was YLC-MS/MS method =1.074Xenzymatic cycling assay + 0.892,R =0.987.Conclusion There is good correlation between LC-MS/MS method and enzymatic cycling assay for the determination of homocysteine concentration in serum,providing a theoretical basis for estimating the concentrations in the same serum sample by the two methods.

Objective To assess the effectiveness and safety of heat moisture exchangers (HMEs) on the artificial airway humid-ification in the mechanically ventilated patients .Methods The related literature in the Cochrane Library ,PubMed ,Embase ,CNKI , VIP ,WanFang database and CBM from the establishment to March 2012 were retrieved ,then included the randomized controlled trial(RCT) and quasi-RCT on the effect of HMEs for the artificial airway humidification in the mechanically ventilated patients were performed the meta analysis by using RevMan 5 .1 .2 software .Results 19 RCT were included(involving 2 960 patients) , which were the random parallel controlled trials .The meta analysis results showed that HMEs could not reduce the incidence rate of ventilator-associated pneumonia(VAP)(RR=0 .78 ,95% CI 0 .61-1 .01 ,P=0 .06) ,also could not decrease the hospitalization mor-tality(RR=0 .94 ,95% CI 0 .83-1 .08 ,P=0 .40) ,the length of ICU stay(MD= -0 .32 ,95% CI -3 .13 -2 .50 ,P=0 .82) and the occurrence rate of catheter occlusion (RR=0 .65 ,95% CI 0 .22 -1 .93 ,P= 0 .44) ,the differences between the two groups had no statistical significance .But 5 RCT reported that using HMEs could reduce the patient′s costs .Conclusion HMEs can not reduce the incidence rate of VAP ,mortality ,length of ICU stay ,occurrence rate of airway occlusion ,but can cut down the patient′s cost . Due to the risk of bias existing in all included RCT and the low quality of the obtained evidences ,more strictly designed and imple-mented RCTs are needed to further verify thse evidences .

Objective:To investigate the clinical application value of ultrasound in the diagnosis and differential diagnosis of Takayasu arteritis (TA ). Methods: A total of 39 suspected TA patients were examined by ultrasonography,erythrocyte sedimentation rate (ESR),C reactive protein (CRP)and CT angiography (CTA), and the ultrasound examination results were compared and analyzed with the final chinical diagnosis results. Results:Of the 39 cases of suspected TA patients which had been examined by ultrasound,33 cases were diagnosed as TA,2 cases were diagnosed as atherosclerosis (AS),2 cases were diagnosed as fibromuscular dysplasia (FMD) and 2 cases were diagnosed as thromboangiitis obliterans (TAO).Compared with final chinical diagnosis results, 1 FMD patient was misdiagnosed as TA,and the rest of the diagnostic results were consistent with the final chinical diagnosis results.Conclusion:Ultrasound examination can provide objective and accurate basis for the diagnosis and differential diagnosis of TA,and it is an effective method of imaging examination.

This paper summarizes the concept of rapid recovery, the its application in trauma orthopeadics of rapid recovery in limb fractures and the future prospect. That rapid rehabilitation is not a pure time acceleration, in patients with perioperative safety and improve the life quality, shorten the hospitalization time and lower cost only its added value, focusing on how to make the patients safe, painless, no cross for perioperative complications. To make the patient with more humanized, individualized, full-dimensional embodiment of professional characteristics of quality care services. It is required that nurses quickly change their ideas, improve their professional knowledge, strengthen communication skills and develop in a more professional direction.

Nisin is an antimicrobial peptide widely used in food industry. In this study, Nisin A production in Lactococcus lactis ATCC 11454 was improved by overexpression of Nisin A structural gene nisA through introducing a shuttle expression vector pMG36ek-nisA and an integrated vector pDG780-nisA into the host strain. The differences of growth profiles and Nisin A production level between the two obtained genetic engineering strains FMM1/FMM2 and the parent strain were investigated. Our results show that while the growth profile (the growth rate, biomass and pH) of FMM1 was similar to the parent strain, its Nisin A production increased 31%. In contrast, the biomass of FMM2 was notably lower than the parent strain, while its yield of Nisin A enhanced slightly. The transcription level of genes involved in Nisin A biosynthesis in both engineering strains was further detected by RT-PCR. We found that all the 11 Nisin A biosynthetic genes in FMM1 and FMM2 had a higher transcription level than those in the parent strain, and these genes exhibited more significant increasing degree of transcription level in FMM1 which hosted the autonomous replicating nisA gene. These data suggest that expression of nisA may act as a rate-limit factor in Nisin A biosynthesis. In conclusion, this work provides a new method to improve Nisin A production by increasing the transcription level of nisA, paving the way to further large-scale industrial production of Nisin A.
Bacterial Proteins ; genetics ; Genes, Bacterial ; Genetic Engineering ; Genetic Vectors ; Lactococcus lactis ; genetics ; metabolism ; Nisin ; biosynthesis ; genetics ; Transcription, Genetic

Due to the reform of medical system, sudden infectious diseases and the increasing demand of patients, the problems of insufficient allocation of human resources and low quality of nursing human resources in China not only affect the treatment and prognosis of patients, but also hinder the development of nursing itself. In order to improve the current situation of nursing staffing in China, this paper summarizes the RAFAELA system of nursing resource allocation in Finland and the need for improvement. In order to promote the improvement and development of the optimal allocation of nursing human resources in China.

Objective:To translate Lee's Visual Analogue Scale for Fatigue (VAS-F) into Chinese, and test its reliability and validity in patients with acute pancreatitis.Methods:We performed translation, back translation and cultural debugging of Lee's VAS-F to form the Chinese version of VAS-F. The expert consultation was used to evaluate the content validity of VAS-F. Convenient sampling was used to select 322 inpatients with acute pancreatitis in the Department of Hepatobiliary Surgery in Affiliated Hospital of Zunyi Medical University from November 2019 to December 2020. The General Information Questionnaire, the Chinese version of VAS-F and the Chinese version of the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) were used for investigation. The discrimination test was used for item analysis, and the reliability and validity of the Chinese version of VAS-F were evaluated through Cronbach's α coefficient, content validity index, exploratory factor analysis, and Pearson correlation analysis.Results:The Chinese version of the VAS-F contained two subscales, namely the Fatigue Severity (13 items) and the Energy Level (5 items) . The Cronbach's α coefficient of the total scale was 0.843, and the Cronbach's α coefficients of the two subscales were 0.965 and 0.959, respectively. The scale-level content validity index of the total scale and the two subscales were 0.89, 0.85 and 1.00, respectively, and the item-level content validity index of each item was from 0.83 to 1.00. After exploratory factor analysis, only one common factor was extracted from the two subscales, and the variance contribution rates were 71.196% and 86.135%, respectively. The factor loads of each item of the two subscales ranged from 0.698 to 0.859 and from 0.852 to 0.906, respectively. The scores of two subscales were negatively correlated ( r=-0.604, P<0.01) , and the total score of Fatigue Severity subscale was negatively correlated with the FACIT-F score ( r=-0.897, P<0.01) . Among 322 patients with acute pancreatitis, there were 3 cases (0.93%) without fatigue, 41 cases (12.73%) with mild fatigue, 181 cases (56.21%) with moderate fatigue and 97 cases (30.12%) with severe fatigue. Conclusions:The Chinese version of VAS-F has good reliability and validity and can be used to measure the fatigue and energy level of patients with acute pancreatitis in China.