Objective To investigate the clinical efficacy of kidney-reinfocing and Du meridian-regulating acupuncture plus ginger moxibustion in treating ankylosing spondylitis. Methods Sixty patients with ankylosing spondylitis were randomly allocated to treatment and control groups, 30 cases each. The treatment group received kidney-reinfocing and Du meridian-regulating acupuncture plus ginger moxibustion and the control group, medication. After three months of treatment, the clinical therapeutic effects were compared between the two groups. Results The cure and marked efficacy rate and the total efficacy rate were 76.7%and 100.0%, respectively, in the treatment group and 53.3%and 70.0%, respectively, in the control group. There were statistically significant differences in both the rates between the two groups (P<0.05). Conclusion Kidney-reinfocing and Du meridian-regulating acupuncture plus ginger moxibustion is an effective way to treat ankylosing spondylitis.

Objective To investigate the cognition level and education demand of occupational protection knowledge among nursing students in clinical practice in the hospitals of Shanghai and analyze its related factors.Methods A cross-sectional survey involving 360 nursing students was conducted in Shanghai.The survey content included occupational protection knowledge,demand and suggestions about setting up occupational protection curricula.Results The mean knowledge score was 5～13 points,with an average of (9.33±1.62)points.In multiple regression models,the level of hospital and educational status were related factors for knowledge level.The occupational protection knowledge mainly from school education accounted for 59.4％,considering it necessary to set up occupational protection curricula accounted for 60.5％.Ways of acquiring occupational protection were:teachers integrating related knowledge into teaching,receiving related education before clinical practice,and being given warning before dangerous operation,accounting for 43.7％,30.8％ and 16.2％.Conclusions Nursing students require a comprehensive foundation course in occupational protection before they enter the clinical practice.This will help to ensure their physical and mental health.

0.05). The incidence of emergency cesarean section in borderline oligohydramnios group was significantly higher than that of the control group. Conclusions Patients with borderline oligohydramnios may have a trial of labor under intensive monitor.

AIM To evaluate the changes of serum and brain tissue endoxin in model of bilateral cerebral hemisphere ischemic reperfusion injury, and effect of anti digoxin antiserum (an antagonist of endoxin). METHODS The bilateral cerebral hemisphere ischemic model was prepared by ligating three vascular by Kameyama's manner. SD rats were randomly divided into 7 groups and each group had 8 rats. Sham group, ischemic reperfusion group, negative control group, nimodipine group, low concentration anti digoxin antiserum group, middle concentration anti digoxin antiserum group, high concentration anti digoxin antiserum group. The blood was collected at the end of reperfusion, meanwhile rats were killed, and the bilateral cerebral hemisphere were took out and used to prepare encephlon homogenate and made into samples of light microscope. RESULTS Compared with sham group, the serum CK content increased; Brain tissue SOD activity reduced and MDA content increased importantly in ischemia reperfusion group; The levels of serum and brain tissue endoxin in ischemia reperfusion group were significantly higher, while ATPase activity in brain tissue decreased; Mitochondrial Ca 2+ content in brain tissue increased significantly and Mg 2+ content decreased significantly. In brain tissue,there was some inflammatory change and local necrosis;The rank order and structure of cell wasn't clear;The morphology of pyramidal cell was abnormal. Compared with ischemic reperfusion group, Anti digoxin antiserum reduced serum CK content; It antagonized lowering of SOD activity and increase of MDA content in brain tissue; It remarkably reduced the level of brain tissue endoxin; It reduced abnormal ion content of brain tissue mitochondrion induced by cerebral ischemic reperfusion injury; The high and middle concentration anti digoxin antiserum had a significant effect on raising brain tissue ATPase activity. It reduced neuron denaturation. CONCLUSION Cerebral ischemic reperfusion can increase the level of brain tissue and serum endoxin and higher endoxin can promote brain injury. Endoxin is a major factor involved in cerebral ischemic reperfusion injury. Anti digoxin antiserum can reduce brain tissue injury and had a protective and treatment effect on cerebral ischemic reperfusion injury by antagonizing the effect of endoxin.

Objective To evaluate the reliability and validity of three-district and four-level triage standards in adult emergency department.Methods A randomized sampling cross-sectional study was conducted. A total of 1106 emergency adult patients admitted to the Second Xiangya Hospital of Central South University in Hunan Province from December 2015 to April 2016 were enrolled. The triage was independently performed by 12 nurses according to the emergency triage criteria. Based on the shift style, 2 nurses were assigned to each shift as the triage guider and assistant respectively, who did the triage for every patient independently. The clinical data were recorded as follows: the demographic data, emergency information (triage time, emergency way, complaints, vital signs, and conscious state), triage information (triage level, admitted department), waiting time, treatment time, destination and outcomes. The reliability of three-district and four-level triage standards was analyzed by Spearman correlation, and the receiver operating characteristic curve (ROC) was plotted to evaluate its validity.Results ① A total of 254 patients were enrolled for reliability evaluation in the first 2 weeks of the study. The overall internal consistency rate ofthe triage instructors and the triage assistants was 72%, the total Kappa value was 0.686 [95% confidence interval (95%CI) = 0.608-0.757,P < 0.001]. ② Validity analysis showed that in the 1125 emergency patients collected during the study, a total of 1106 patients were finally enrolled in the analysis excluding the patients who refused to accept the treatment, whose data was incomplete and who was diagnosed as prehospital death. With the increase of three-district and four-level triage level, a significant increase was showed in the waiting time of patients, the treatment time, and the retention rate; on the contrary, the salvage rate, the hospitalization rate, hospitalization time, emergency mortality, in-hospital mortality and total mortality rate were decreased [the waiting time of patients from triage level 1 to 4 (minutes) was 1.00 (1.00, 1.75), 1.00 (1.00, 5.00), 8.00 (2.00, 23.00), 10.00 (4.50, 28.00), the treatment received time (minutes) was 1.00 (1.00, 10.00), 6.00 (1.00, 23.00), 48.00 (25.00, 105.00), 87.00 (41.00, 140.00), the retention rate was 4.76%, 10.94%, 55.91%, 42.86%, the salvage rate was 95.24%, 87.94%, 20.81%, 0%, the hospitalization rate was 57.14%, 70.98%, 53.62%, 20.41%, the hospitalization time (days) was 19.50 (9.75, 28.00), 11.00 (8.00, 17.00), 12.00 (8.25, 17.00), 10.50 (8.75, 15.25), the emergency mortality was 19.05%, 6.92%, 1.41%, 0%, the in-hospital mortality was 16.67%, 15.09%, 6.25%, 0%, and the total mortality rate was 28.57%, 17.63%, 4.76%, 0%, allP < 0.05]. ROC curve analysis showed that the area under ROC curve (AUC) of three-district and four-level triage standards for identifying patients needed an immediate intervention (triage level 1 to 2) was 0.854 (95%CI = 0.831-0.878), and the sensitivity and specificity were 78.62% and 89.89%, respectively, the misdiagnosis rate was 10.11%, and the missed diagnosis rate was 21.38%.Conclusion The three-district and four-level triage standards were proved to be a reliable and valid instrument, which can distinguish the severity of the disease and help nurses to triage patients correctly.

Humans ; Liver Cirrhosis ; diagnosis

Objective To study the effects of a cirrhotic environment on the metastasis of liver cancer in mice.Methods Male BALB/c mice were randomly assigned to two groups:cirrhosis group and control group.The cirrhosis group was treated by an injection of carbon tetrachloride intraperitoneally.H22 liver cancer cells were directly implanted under the capsule of each group after cirrhosis was established.The animals were sacrificed at 1,2,and 3 weeks after the operation.The metastatic behavior of the cancer cells was observed by the naked eye and microscopically.Additionally,the adhesion ability of the liver was assessed by measuring the expression of vascular cell adhesion molecule 1 (VCAM-1),E-selectin,and E-cadherin.Results After the operation,the cirrhosis group showed an obvious metastatic tendency in both intrahepatic (14/19) and extrahepatic ways (4/19),compared with the control group's intrahepatic (5/17) and extrahepatic ways (1/17) (P＜0.05).Immunohistochemisty for VCAM-1 and E-selectin showed a significant increase in the cirrhosis (P＜0.05).However,there was no difference observed in the E-cadherin between the cirrhosis and control group.Conclusion A cirrhotic liver environment may promote the metastasis of liver cancer cells by increasing the ability of liver adhesion.

Objective: To investigate the relationship between blood pressure, blood glucose or blood lipids and patients with cerebral infarction (CI) or intracerebral hemorrhage (ICH) in diff erent age or gender. Methods: hT e case-control study consecutively recruited patients with if rst-ever-in-a-lifetime CI (n=358) and ICH (n=230) and community-acquired pneumonia (n=165) as controls between January 2010 and December 2013 at the Second Xiangya Hospital of Central South University. hT epatients with CI or ICH were divided into the young group, the middle-aged group and the older group, and the risk factors were compared between the 3 groups. hTe patients with CI or ICH were respectively further divided into the male group and the female group. hTe blood pressure, glucose and lipids were measured. Results: Data from logistic regression models showed that CI was closely associated with high blood pressure, hypertension, diabetes mellitus (DM) or fasting plasma glucose (FPG) (P<0.05), and ICH was closely related to high blood pressure, hypertension, low density lipoprotein-cholesterol (LDL-C), FPG, serum creatinine (SCr) or alcohol drinking (P<0.05); hypertension was the main risk factor for stroke. hTe odds ratios for the young, the middle-aged and older group were 10.43, 4.74 and 7.39 respectively (P<0.05). Systolic blood pressure (OR=28.74) was the important risk factor for the young stroke, and the OR is 2.81 for the middle-aged stroke. Diastolic blood pressure (OR=2.96) and DM (OR=6.25) were the risk factor for the middle-aged stroke. LDL-C (OR=2.87) was a risk factor for the older stroke; the mean levels of diastolic blood pressure in males were signiifcantly increased compared with that in females with CI, while the mean levels of TC, HDL-C or LDL-C in females were signiifcantly higher than that in males with ICH (P<0.05). Conclusion: Hypertension, systolic blood pressure in particular, is the most common risk factor for young stroke patients. DM and hypertension are the risk factors for the middle-aged patients, while hypertension, DM, LDL-C and alcohol consuming are the risk factors for the aged patients.

Objective To assess whether there was strong association between antiphospholipid antibodies(APA) and coronary heart disease(CHD), to study the environmental factors of APA production and APA pathogenic mechanism in patients with CHD.Methods Blood samples from 76 patients with CHD and 30 controls were tested for anticardiolipin antibodies IgG(ACA-IgG),human cytomegalovirus IgG,IgM(HCMV-IgG,IgM) by enzyme-link immunosorbant assay(ELISA) and 6-keto-PGF1a,endothelin(ET) by radioimmunoassay(RIA).Results A total of 27 patients(35.53%) were ACA positive in 76, as compared to 2 of 30(6.67%) healthy individuals, P＜0.05. There was no difference in ACA among acute myocardial infarction(AMI,39.13%), old myocardial infarction(OMI,26.53%), unstable angina pectoris(UA,38.40%), P＞0.05. The number of ACA positive subjects was higher in HCMV infection patients with CHD than no HCMV infectious patients with CHD. There was no PGI2 and ET level difference between ACA-IgG positive and negative CHD.Conclusion There are strong association between APA and CHD. The HCMV infection may be an environmental factor of APA production in CHD patients with raised ACA. The alteration of PGI2 and ET are not the pathogenic mechanism of ACA in patients with CHD.

Objective To determine the optimal condition for labeling rat bone marrow mesenchymal stem cells(MSCs) with green fluorescent protein(GFP)infection by lentiviral vector so as to establish a subgroup of MSCs which have a high level of GFP expression.Methods MSCs were infected with GFP by lentiviral vector for 12h or 24h at different MOI(25,50,100,200 and 400).The infection efficiency and fluorescence intensity were analyzed by inverted fluorescent microscopy and flow cytometry.The effect of infection at different MOI on proliferation of MSCs was evaluated by MTT.Based on those mentioned above,we could determine the optimal condition for infection.Then single cell clones of MSCs labeled with GFP under optimal condition were selected by using cloning rings.Results The efficiency of infection for 24h at MOI 100,200 and 400 was 88.94%,99.65% and 99.42%,respectively.The infection had no significant effect on the proliferation of MSCs infected at MOI 100 or 200,compared with MSCs without infection.However,those MSCs infected at MOI 400 proliferated slowly.The rate of GFP expression on single-cell clone of MSCs infected for 24h at MOI 200 was 99.95%,and their fluorescence intensity was strong and uniform.Conclusion Infection for 24h at MOI 200 is optimal for labeling rat bone marrow MSCs with GFP by a lentiviral vector.A subgroup of MSCs which have a stably high level of GFP expression can be obtained by single cell cloning technique.